OBJECTIVES: To test the cost-effectiveness of a home-based depression program: Beat the Blues (BTB). DESIGN: A cost-effectiveness analysis as part of a previously reported randomized controlled trial that compared BTB with a wait-list control group. SETTING: Community. PARTICIPANTS: English-speaking, cognitively intact (Mini-Mental State Examination score ≥24), African Americans aged 55 and older with depressive symptoms (Patient Health Questionnaire score ≥5) (N = 129). INTERVENTION: Participants randomly assigned to BTB received up to 10 home visits over 4 months from licensed social workers who provided care management, referral and linkage, stress reduction, depression education, and behavioral activation to help participants achieve self-identified goals. MEASUREMENTS: Incremental cost-effectiveness ratios (ICERs) of BTB versus wait-list controls during the 4-month study period. The primary ICER was defined as cost per quality-adjusted life year (QALY) using the Euro Quality of Life 5D (EQ-5D) and secondarily using the Health Utilities Index-3 (HUI-3). Additional ICERs were calculated using clinical measures (cost per depression improvement, cost per depression remission). Costs included BTB intervention, depression-related healthcare visits and medications, caregiver time, and social services. RESULTS:BTB cost per participant per month was $146. Base case ICERs were $64,896 per QALY (EQ-5D) and $36,875 per QALY (HUI-3). Incremental cost was $2,906 per depression improvement and $3,507 per remission. Univariate and probabilistic sensitivity analyses yielded a cost/QALY range of $20,500 to $76,500. CONCLUSION: Based on the range of cost-effectiveness values resulting from this study, BTB is a cost-effective treatment for managing depressive symptoms in older African Americans that compares favorably with the cost-effectiveness of previously tested approaches.
RCT Entities:
OBJECTIVES: To test the cost-effectiveness of a home-based depression program: Beat the Blues (BTB). DESIGN: A cost-effectiveness analysis as part of a previously reported randomized controlled trial that compared BTB with a wait-list control group. SETTING: Community. PARTICIPANTS: English-speaking, cognitively intact (Mini-Mental State Examination score ≥24), African Americans aged 55 and older with depressive symptoms (Patient Health Questionnaire score ≥5) (N = 129). INTERVENTION: Participants randomly assigned to BTB received up to 10 home visits over 4 months from licensed social workers who provided care management, referral and linkage, stress reduction, depression education, and behavioral activation to help participants achieve self-identified goals. MEASUREMENTS: Incremental cost-effectiveness ratios (ICERs) of BTB versus wait-list controls during the 4-month study period. The primary ICER was defined as cost per quality-adjusted life year (QALY) using the Euro Quality of Life 5D (EQ-5D) and secondarily using the Health Utilities Index-3 (HUI-3). Additional ICERs were calculated using clinical measures (cost per depression improvement, cost per depression remission). Costs included BTB intervention, depression-related healthcare visits and medications, caregiver time, and social services. RESULTS:BTB cost per participant per month was $146. Base case ICERs were $64,896 per QALY (EQ-5D) and $36,875 per QALY (HUI-3). Incremental cost was $2,906 per depression improvement and $3,507 per remission. Univariate and probabilistic sensitivity analyses yielded a cost/QALY range of $20,500 to $76,500. CONCLUSION: Based on the range of cost-effectiveness values resulting from this study, BTB is a cost-effective treatment for managing depressive symptoms in older African Americans that compares favorably with the cost-effectiveness of previously tested approaches.
Authors: Wayne J Katon; Michael Schoenbaum; Ming-Yu Fan; Christopher M Callahan; John Williams; Enid Hunkeler; Linda Harpole; Xiao-Hua Andrew Zhou; Christopher Langston; Jürgen Unützer Journal: Arch Gen Psychiatry Date: 2005-12
Authors: Jane L Givens; Catherine J Datto; Katy Ruckdeschel; Kathryn Knott; Cynthia Zubritsky; David W Oslin; Soumya Nyshadham; Poornima Vanguri; Frances K Barg Journal: J Gen Intern Med Date: 2005-12-07 Impact factor: 5.128
Authors: Jeffrey M Pyne; Kathryn M Rost; Mingliang Zhang; D Keith Williams; Jeffrey Smith; John Fortney Journal: J Gen Intern Med Date: 2003-06 Impact factor: 5.128
Authors: Erlend Faltinsen; Adnan Todorovac; Laura Staxen Bruun; Asbjørn Hróbjartsson; Christian Gluud; Mickey T Kongerslev; Erik Simonsen; Ole Jakob Storebø Journal: Cochrane Database Syst Rev Date: 2022-04-04
Authors: Danielle L Beatty Moody; Daniel K Leibel; Elizabeth J Pantesco; Carrington R Wendell; Shari R Waldstein; Michele K Evans; Alan B Zonderman Journal: Psychosom Med Date: 2020 Feb/Mar Impact factor: 3.864