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  1. Cost-effectiveness of treatments for major depression in primary care practice.

    Article - En anglais

    Background 

    This study augments a randomized controlled trial to analyze the cost-effectiveness of 2 standardized treatments for major depression relative to each other and to the « usual care » provided by primary care physicians.

    Methods 

    A randomized controlled trial was conducted in which primary care patients meeting DSM-III-R criteria for current major depression were assigned to pharmacotherapy (where nortriptyline hydrochloride was given) or interpersonal psychotherapy provided in a standardized framework or a primary physician's usual care.

    Two outcome measures, depression-free days and quality-adjusted days, were developed using information on depressive symptoms over time.

    The costs of care were calculated.

    Cost-effectiveness ratios comparing the incremental outcomes with the incremental costs for the different treatments were estimated.

    Sensitivity analyses were performed.

    Results 

    In terms of both economic costs and quality-of-life outcomes, patients assigned to the pharmacotherapy group did slightly better than those assigned to interpersonal psychotherapy.

    Both standardized therapies provided better outcomes than primary physician's usual care, but each consumed more resources.

    No meaningful cost-offsets were found.

    The incremental direct cost per additional depression-free day for pharmacotherapy relative to usual care ranges from $12.66 to $16.87 which translates to direct cost per quality-adjusted year gained from $11 270 to $19 510. (...)

    Mots-clés Pascal : Etat dépressif, Traitement, Chimiothérapie, Nortriptyline, Antidépresseur, Psychotrope, Etude comparative, Psychothérapie, Analyse coût, Efficacité traitement, Economie santé, Soin santé primaire, Santé mentale, Homme, Composé tricyclique, Trouble humeur

    Mots-clés Pascal anglais : Depression, Treatment, Chemotherapy, Nortriptyline, Antidepressant agent, Psychotropic, Comparative study, Psychotherapy, Cost analysis, Treatment efficiency, Health economy, Primary health care, Mental health, Human, Tricyclic compound, Mood disorder

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0457628

    Code Inist : 002B02B02. Création : 25/01/1999.