Cost-effectiveness of a stepped care program to prevent depression among primary care patients with diabetes mellitus type 2 and/or coronary heart disease and subthreshold depression in comparison with usual care

Table 3 Results of the cost-effectiveness analyses

Outcome	Mean cost difference (95% CI)	Mean effect difference (95% CI)	ICER	Distribution of the Cost-Effectiveness plane (%)
Outcome	Mean cost difference (95% CI)	Mean effect difference (95% CI)	ICER	North-East	South-East	South-West	North-West
Main analyses^a
Cases of major depression prevented	€1125 (€-2942; €5343)	−0.024 (− 0.118; 0.070)	−46,802	19%	11%	21%	49%
QALYs (EQ-5D)	€919 (€-3133; €5145)	0.010 (−0.0269; 0.0474)	88,898	41%	30%	5%	24%
Severity of depressive symptoms (PHQ-9)	€923 (€-3151; €5073)	0.077 (−1.546; 1.701)	11,927	32%	23%	12%	33%
Perceived recovery	€1125 (€-2987; €5343)	0.011 (−0.156; 0.177)	107,353	38%	17%	14%	31%
Sensitivity analyses 1: Crude analyses^b
Cases of major depression prevented	€ 1001 (€-3543; €5852)	−0.018 (− 0.113; 0.077)	−55,779	20%	16%	20%	44%
QALYs (EQ-5D)	€ 1001 (€-3547; €5780)	0.001 (−0.457; 0.479)	939,235	26%	26%	9%	36%
Severity of depressive symptoms (PHQ-9)	€ 1001 (€-3577; €5797)	0.096 (−1.646; 1.454)	10,429	32%	23%	12%	33%
Perceived recovery	€ 1001 (€-3540; €5800)	−0.027 (− 0.162; 0.156)	− 373,720	32%	17%	19%	32%
Sensitivity analyses 2: analyses from NHS perspective^c
Cases of major depression prevented	€1422 (€-578; 3167)	−0.024 (− 0.118; 0.070)	−58,733	27%	3%	5%	65%
QALYs (EQ-5D)	€1369 (€-590; 3110)	0.010 (−0.0274; 0.0469)	140,088	60%	8%	2%	30%
Severity of depressive symptoms (PHQ-9)	€1398 (€-596; 3154)	0.077 (−1.541; 1.695)	18,174	49%	6%	3%	42%
Perceived recovery	€1422 (€-541; 3173)	0.0126 (−0.153; 0.179)	112,624	53%	4%	4%	39%

CI Confidence Interval; MINI Mini International Neuropsychiatric Interview; EQ-5D-5L EuroQo-5Dimensions 5 Levels; PHQ-9 Patient Health Questionnarie-9; NHS National Health Service (United Kingdom)
^a Costs from a societal perspective are analyzed. All analyses are corrected for baseline values of costs from a societal perspective and the effect, gender, age and other possible confounders: marital status, employment status, level of education, co-existence of DM2 and CHD, alcohol use, number of depressive episodes in history and age of onset of depression
^b Costs from a societal perspective are analyzed. The analyses are not corrected for baseline values of costs and effects, nor for possible confounders
^c Costs from a NHS perspective are analyzed. All analyses are corrected for baseline values of costs from NHS perspective and the effect, gender, age and other possible confounders: marital status, employment status, level of education, co-existence of DM2 and CHD, alcohol use, number of depressive episodes in history and age of onset of depression

ISSN: 1471-244X