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. 2023 Jun 13;66(1):e57.
doi: 10.1192/j.eurpsy.2023.2415.

Economic impact of reducing treatment gaps in depression

Paul McCrone  1 , Allan H Young  2   3 , Roland Zahn  2 , Jonas Eberhard  4 , Danuta Wasserman  5 , Paolo Brambilla  6   7 , Judit Balazs  8   9 , Jose Caldas-de-Almeida  10 , Andrea Ulrichsen  2 , Vladmir Carli  5 , Ana Antunes  10 , Giandomenico Schiena  6 , Vinciane Quoidbach  11 , Patrice Boyer  11 , Rebecca Strawbridge  2
Affiliations

Economic impact of reducing treatment gaps in depression

Paul McCrone et al. Eur Psychiatry. .

Abstract

Background: Major depressive disorder (MDD) is highly prevalent across Europe. While evidence-based treatments exist, many people with MDD have their condition undetected and/or untreated. This study aimed to assess the cost-effectiveness of reducing treatment gaps using a modeling approach.

Methods: A decision-tree model covering a 27-month time horizon was used. This followed a care pathway where MDD could be detected or not, and where different forms of treatment could be provided. Expected costs pertaining to Germany, Hungary, Italy, Portugal, Sweden, and the UK were calculated and quality-adjusted life years (QALYs) were estimated. The incremental costs per QALY of reducing detection and treatment gaps were estimated.

Results: The expected costs with a detection gap of 69% and treatment gap of 50% were €1236 in Germany, €476 in Hungary, €1413 in Italy, €938 in Portugal, €2093 in Sweden, and €1496 in the UK. The incremental costs per QALY of reducing the detection gap to 50% ranged from €2429 in Hungary to €10,686 in Sweden. The figures for reducing the treatment gap to 25% ranged from €3146 in Hungary to €13,843 in Sweden.

Conclusions: Reducing detection and treatment gaps, and maintaining current patterns of care, is likely to increase healthcare costs in the short term. However, outcomes are improved, and reducing these gaps to 50 and 25%, respectively, appears to be a cost-effective use of resources.

Keywords: cost; depression; economics; gaps; treatment.

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Conflict of interest statement

P.M. has received honoraria from Lundbeck and Janssen-Cilag. R.S. has received honoraria from Lundbeck. A.H.Y. has been commissioned to provide lectures and advice to all major pharmaceutical companies with drugs used in affective and related disorders, and has also undertaken investigator-initiated studies funded by Astra Zeneca, Eli Lilly, Lundbeck, and Wyeth. R.Z. is a private psychiatrist service provider at The London Depression Institute; is a co-investigator on a Livanova-funded observational study of Vagus Nerve Stimulation for Depression; has received honoraria for talks at medical symposia sponsored by Lundbeck and Janssen; has collaborated with EMIS PLC and advises Depsee Ltd.; is affiliated with the D’Or Institute of Research and Education, Rio de Janeiro; and advises the Scients Institute, USA. S.B. is undertaking a study by Boehringer Ingelheim. A.A. is an employee of IQVIA. V.Q. is employed at the EBC (funder), and P.Bo. undertakes work for the EBC. J.E., D.W., P.Br., J.B., J.C-d-A., A.U., and G.S. declare none.

Figures

Figure 1.
Figure 1.
Decision model to assess economic impact of reducing treatment gaps (reduced model).
Figure 2.
Figure 2.
Incremental cost per QALY of reducing detection and treatment gaps.
See this image and copyright information in PMC

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