Michaela Modin Asper1, Nino Hallén1, Lene Lindberg2, Anna Månsdotter3, Magdalena Carlberg4, Michael B Wells5. 1. Learning, Informatics, Management, and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden. 2. Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Center for Epidemiology and Community Medicine, Stockholm County Council. 3. Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Department of Public Health and Clinical Medicine, Unit of Epidemiology and Global Health, Umeå University, Umeå, Sweden. 4. Health and Medical Care Administration, Stockholm County Council, Stockholm, Sweden. 5. Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. Electronic address: michael.wells@ki.se.
Abstract
BACKGROUND: Postpartum depression negatively affects the whole family and its prevalence in Sweden ranges between 6-10% for fathers and 13-16% for mothers. However, only mothers in Sweden are currently routinely screened. AIM: The aim of this study was to determine if a postpartum depression screening for fathers in Stockholm County could be cost-effective. METHODS: National Swedish databases were used to find registry data and a literature review was undertaken to identify the model data inputs associated with postpartum depression in Sweden. The generated evidence was used to build a Markov model in TreeAge. One-way and probabilistic sensitivity analyses were performed to account for parameter uncertainties. Alternative scenario analyses were further undertaken to test the assumptions in the base case analysis. RESULTS: A postpartum screening for depression in fathers is cost-effective in base case and alternative scenarios. The results indicate that the screening program is associated with lower costs and higher health effects. The results were sensitive to variables of quality adjusted life years for the depressed fathers, probabilities of remission in treatment and no treatment groups and start age and productivity losses. The probabilistic sensitivity analysis resulted in a 70% probability of the postnatal depression screening intervention being cost-effective. LIMITATIONS: The current study only uses secondary data; therefore future research should assess the cost-effectiveness of screening fathers for depression. CONCLUSION: The postpartum screening intervention for fathers could be cost-effective compared to no screening. Future research should replicate the potential cost-effectiveness for screening fathers for postpartum depression.
BACKGROUND:Postpartum depression negatively affects the whole family and its prevalence in Sweden ranges between 6-10% for fathers and 13-16% for mothers. However, only mothers in Sweden are currently routinely screened. AIM: The aim of this study was to determine if a postpartum depression screening for fathers in Stockholm County could be cost-effective. METHODS: National Swedish databases were used to find registry data and a literature review was undertaken to identify the model data inputs associated with postpartum depression in Sweden. The generated evidence was used to build a Markov model in TreeAge. One-way and probabilistic sensitivity analyses were performed to account for parameter uncertainties. Alternative scenario analyses were further undertaken to test the assumptions in the base case analysis. RESULTS: A postpartum screening for depression in fathers is cost-effective in base case and alternative scenarios. The results indicate that the screening program is associated with lower costs and higher health effects. The results were sensitive to variables of quality adjusted life years for the depressed fathers, probabilities of remission in treatment and no treatment groups and start age and productivity losses. The probabilistic sensitivity analysis resulted in a 70% probability of the postnatal depression screening intervention being cost-effective. LIMITATIONS: The current study only uses secondary data; therefore future research should assess the cost-effectiveness of screening fathers for depression. CONCLUSION: The postpartum screening intervention for fathers could be cost-effective compared to no screening. Future research should replicate the potential cost-effectiveness for screening fathers for postpartum depression.