Anne Sauvaget1, Agathe Tostivint2, François Etcheverrigaray3, Anne Pichot2, Cécile Dert4, Solène Schirr-Bonnais4, Johann Clouet5, Olivier Sellal6, Nicolas Mauduit7, Christophe Leux7, Clémence Cabelguen2, Samuel Bulteau8, Valéry-Pierre Riche4. 1. Addictology and liaison psychiatry department, Nantes university hospital, CHU de Nantes, Nantes, France; Laboratory "movement, interactions, performance" (EA 4334), faculty of sport sciences, university of Nantes, Nantes, France. Electronic address: anne.sauvaget@chu-nantes.fr. 2. Addictology and liaison psychiatry department, Nantes university hospital, CHU de Nantes, Nantes, France. 3. Pharmacie, centre hospitalier départemental (CHD) Vendée, 85925 La Roche-sur-Yon, France. 4. Innovation cell, partnership and innovation department, directorate of medical affairs and research, CHU de Nantes, Nantes, France. 5. INSERM, UMR 1229, RMeS, regenerative medicine and skeleton, université de Nantes, ONIRIS, 44042 Nantes, France; Pharmacie Centrale, CHU Nantes, PHU 11, 44093 Nantes, France; UFR sciences biologiques et pharmaceutiques, université de Nantes, 44035 Nantes, France; UFR odontologie, université de Nantes, 44042 Nantes, France. 6. Pharmacie Centrale, CHU Nantes, PHU 11, 44093 Nantes, France. 7. Department of medical information, CHU de Nantes, Nantes, France. 8. Addictology and liaison psychiatry department, Nantes university hospital, CHU de Nantes, Nantes, France; Inserm U1246 Sphere "methodS in Patient-centered outcomes and HEalth ResEarch", Nantes university, institute of health research IRS, 44200 Nantes, France.
Abstract
OBJECTIVES: Due to its ease of use, tolerance, and cost of acquisition, transcranial direct current stimulation (tDCS) could constitute a credible therapeutic option for non-resistant depression in primary care, when combined with drug management. This indication has yet to receive official recognition in France. The objective of this study is to evaluate the production cost of tDCS for the treatment of depression in hospitals, under realistic conditions. METHODS: The methodology adopted is based on cost accounting and was validated by a multidisciplinary working group. It includes equipment, staff, and structural costs to obtain the most realistic estimate possible. We first estimated the cost of producing a tDCS session, based on our annual activity objective, and then estimated the cost of a 15-session treatment program. This was followed up with a sensitivity analysis applying appropriate parameters. RESULTS: The hospital production cost of a tDCS depression treatment program for a single patient was estimated at €1555.60 euros: €99 in equipment costs, €1076.95 in staff costs, and €379.65 in structural costs. CONCLUSION: This cost analysis should make it possible to draw up pricing proposals in compliance with regulations and health policy choices and to develop health-economic studies. This would ultimately lead to official recognition of tDCS treatment for depression in France and pave the way for studying various scenarios of coverage by the French national health insurance system.
OBJECTIVES: Due to its ease of use, tolerance, and cost of acquisition, transcranial direct current stimulation (tDCS) could constitute a credible therapeutic option for non-resistant depression in primary care, when combined with drug management. This indication has yet to receive official recognition in France. The objective of this study is to evaluate the production cost of tDCS for the treatment of depression in hospitals, under realistic conditions. METHODS: The methodology adopted is based on cost accounting and was validated by a multidisciplinary working group. It includes equipment, staff, and structural costs to obtain the most realistic estimate possible. We first estimated the cost of producing a tDCS session, based on our annual activity objective, and then estimated the cost of a 15-session treatment program. This was followed up with a sensitivity analysis applying appropriate parameters. RESULTS: The hospital production cost of a tDCS depression treatment program for a single patient was estimated at €1555.60 euros: €99 in equipment costs, €1076.95 in staff costs, and €379.65 in structural costs. CONCLUSION: This cost analysis should make it possible to draw up pricing proposals in compliance with regulations and health policy choices and to develop health-economic studies. This would ultimately lead to official recognition of tDCS treatment for depression in France and pave the way for studying various scenarios of coverage by the French national health insurance system.
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