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  • Cited by 14
  • Cited by
    Crossref Citations
    Crossref logo
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.
    Petersen, Juliana J. Hartig, Johannes Paulitsch, Michael A. Pagitz, Manuel Mergenthal, Karola Rauck, Sandra Reif, Andreas Gerlach, Ferdinand M. Gensichen, Jochen and Hoch, Renee 2018. Classes of depression symptom trajectories in patients with major depression receiving a collaborative care intervention. PLOS ONE, Vol. 13, Issue. 9, p. e0202245.
    Gensichen, Jochen Stefan and Linde, Andreas 2018. Lehrbuch der Verhaltenstherapie, Band 1. p. 709.
    Backhouse, Amy Ukoumunne, Obioha C. Richards, David A. McCabe, Rose Watkins, Ross and Dickens, Chris 2017. The effectiveness of community-based coordinating interventions in dementia care: a meta-analysis and subgroup analysis of intervention components. BMC Health Services Research, Vol. 17, Issue. 1,
    Petersen, Juliana J. and Gensichen, Jochen 2017. Altersdepression. p. 311.
    Parker, Ramona Ann Hook, Linda D. and Jones, Mary Elaine 2016. Glycemic control. Journal of the American Association of Nurse Practitioners, Vol. 28, Issue. 12, p. 652.
    Thorrington, Dominic Eames, Ken and Green, Colin 2015. Measuring Health Utilities in Children and Adolescents: A Systematic Review of the Literature. PLOS ONE, Vol. 10, Issue. 8, p. e0135672.
    Alberti, Siegfried Chiesa, Alberto Andrisano, Costanza and Serretti, Alessandro 2015. Insomnia and Somnolence Associated With Second-Generation Antidepressants During the Treatment of Major Depression. Journal of Clinical Psychopharmacology, Vol. 35, Issue. 3, p. 296.
    Aragonès, Enric López-Cortacans, Germán Sánchez-Iriso, Eduardo Piñol, Josep-Lluís Caballero, Antonia Salvador-Carulla, Luis and Cabasés, Juan 2014. Cost-effectiveness analysis of a collaborative care programme for depression in primary care. Journal of Affective Disorders, Vol. 159, Issue. , p. 85.
    Jacke, Christian Olaf and Salize, Hans-Joachim 2014. Kosteneffektivität eines krankenkassengestützten Case-Management-Programms für Patienten mit affektiven Störungen. neuropsychiatrie, Vol. 28, Issue. 3, p. 130.
    Krauth, Christian Stahmeyer, Jona T. Petersen, Juliana J. Freytag, Antje Gerlach, Ferdinand M. and Gensichen, Jochen 2014. Resource Utilisation and Costs of Depressive Patients in Germany: Results from the Primary Care Monitoring for Depressive Patients Trial. Depression Research and Treatment, Vol. 2014, Issue. , p. 1.
    Johnson, Jeffrey A. Al Sayah, Fatima Wozniak, Lisa Rees, Sandra Soprovich, Allison Qiu, Weiyu Chik, Constance L. Chue, Pierre Florence, Peter Jacquier, Jennifer Lysak, Pauline Opgenorth, Andrea Katon, Wayne and Majumdar, Sumit R. 2014. Collaborative Care Versus Screening and Follow-up for Patients With Diabetes and Depressive Symptoms: Results of a Primary Care–Based Comparative Effectiveness Trial. Diabetes Care, Vol. 37, Issue. 12, p. 3220.
    Petersen, Juliana J. König, Jochem Paulitsch, Michael A. Mergenthal, Karola Rauck, Sandra Pagitz, Manuel Schmidt, Konrad Haase, Lydia Gerlach, Ferdinand M. and Gensichen, Jochen 2014. Long-term effects of a collaborative care intervention on process of care in family practices in Germany: a 24-month follow-up study of a cluster randomized controlled trial. General Hospital Psychiatry, Vol. 36, Issue. 6, p. 570.
    2013. Depression case management an attractive option in primary care. PharmacoEconomics & Outcomes News, Vol. 677, Issue. 1, p. 6.
    Sonntag, Michael König, Hans-Helmut and Konnopka, Alexander 2013. The Estimation of Utility Weights in Cost-Utility Analysis for Mental Disorders: A Systematic Review. PharmacoEconomics, Vol. 31, Issue. 12, p. 1131.
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Cost-effectiveness of depression case management in small practices

  • Jochen Gensichen (a1), Juliana J. Petersen (a2), Michael Von Korff (a3), Dirk Heider (a4), Steffen Baron (a2), Jochem König (a5), Antje Freytag (a6), Christian Krauth (a7), Ferdinand M. Gerlach (a2) and Hans-Helmut König (a8)...
Abstract
Background

Case management undertaken by healthcare assistants in small primary care practices is effective in improving depression symptoms and adherence in patients with major depression.

Aims

To evaluate the cost-effectiveness of depression case management by healthcare assistants in small primary care practices.

Method

Cost-effectiveness analysis on the basis of a pragmatic randomised controlled trial (2005-2008): practice-based healthcare assistants in 74 practices provided case management to 562 patients with major depression over 1 year. Our primary outcome was the incremental costeffectiveness ratio (ICER) calculated as the ratio of differences in mean costs and mean number of qualityadjusted life-years (QALYs). Our secondary outcome was the mean depression-free days (DFDs) between the intervention and control group at 24-month follow-up. The study was registered at the International Standard Randomised Controlled Trial Number Registry: ISRCTN66386086.

Results

Intervention v. control group: no significant difference in QALYs; significantly more DFDs (mean: 373 v. 311, P<0.01); no significant difference in mean direct healthcare costs (€4495 v. €3506, P = 0.16); considerably lower mean indirect costs (€5228 v. €7539, P = 0.06), resulting in lower total costs (€9723 v. €11 045, P = 0.41). The point estimate for the cost-utility ratio was €38 429 per QALY gained if only direct costs were considered, and ‘dominance’ of the intervention if total costs were considered. Yet, regardless of decision makers' willingness to pay per QALY, the probability of the intervention being cost-effective was never above 90%.

Conclusions

In small primary care practices, 1 year of case management did not increase the number of QALYs but it did increase the number of DFDs. The intervention was likely to be cost-effective.

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Copyright
COPYRIGHT: © Royal College of Psychiatrists, 2013 
Corresponding author
Jochen Gensichen, MD, MA, MPH, Institute of General Practice and FamilyMedicine, Friedrich-Schiller-University/Jena University Hospital, Bachstr. 18, D-07743 Jena, Germany. Email: jochen.gensichen@med.uni-jena.de
Footnotes
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∗

This paper was presented in an oral presentation at the 46th Congress of the German College of General Practitioners and Family Physicians in Salzburg, Austria, on 22-24 September 2011 and by poster at the European Conference on Health Economics (ECHE) in Zurich, Switzerland, on 18-21 July 2012.

∗∗

These authors contributed equally to the work.

Declaration of interest

None.

Footnotes
References
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  • Cited by 14
  • Cited by
    Crossref Citations
    Crossref logo
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.
    Petersen, Juliana J. Hartig, Johannes Paulitsch, Michael A. Pagitz, Manuel Mergenthal, Karola Rauck, Sandra Reif, Andreas Gerlach, Ferdinand M. Gensichen, Jochen and Hoch, Renee 2018. Classes of depression symptom trajectories in patients with major depression receiving a collaborative care intervention. PLOS ONE, Vol. 13, Issue. 9, p. e0202245.
    Gensichen, Jochen Stefan and Linde, Andreas 2018. Lehrbuch der Verhaltenstherapie, Band 1. p. 709.
    Backhouse, Amy Ukoumunne, Obioha C. Richards, David A. McCabe, Rose Watkins, Ross and Dickens, Chris 2017. The effectiveness of community-based coordinating interventions in dementia care: a meta-analysis and subgroup analysis of intervention components. BMC Health Services Research, Vol. 17, Issue. 1,
    Petersen, Juliana J. and Gensichen, Jochen 2017. Altersdepression. p. 311.
    Parker, Ramona Ann Hook, Linda D. and Jones, Mary Elaine 2016. Glycemic control. Journal of the American Association of Nurse Practitioners, Vol. 28, Issue. 12, p. 652.
    Thorrington, Dominic Eames, Ken and Green, Colin 2015. Measuring Health Utilities in Children and Adolescents: A Systematic Review of the Literature. PLOS ONE, Vol. 10, Issue. 8, p. e0135672.
    Alberti, Siegfried Chiesa, Alberto Andrisano, Costanza and Serretti, Alessandro 2015. Insomnia and Somnolence Associated With Second-Generation Antidepressants During the Treatment of Major Depression. Journal of Clinical Psychopharmacology, Vol. 35, Issue. 3, p. 296.
    Aragonès, Enric López-Cortacans, Germán Sánchez-Iriso, Eduardo Piñol, Josep-Lluís Caballero, Antonia Salvador-Carulla, Luis and Cabasés, Juan 2014. Cost-effectiveness analysis of a collaborative care programme for depression in primary care. Journal of Affective Disorders, Vol. 159, Issue. , p. 85.
    Jacke, Christian Olaf and Salize, Hans-Joachim 2014. Kosteneffektivität eines krankenkassengestützten Case-Management-Programms für Patienten mit affektiven Störungen. neuropsychiatrie, Vol. 28, Issue. 3, p. 130.
    Krauth, Christian Stahmeyer, Jona T. Petersen, Juliana J. Freytag, Antje Gerlach, Ferdinand M. and Gensichen, Jochen 2014. Resource Utilisation and Costs of Depressive Patients in Germany: Results from the Primary Care Monitoring for Depressive Patients Trial. Depression Research and Treatment, Vol. 2014, Issue. , p. 1.
    Johnson, Jeffrey A. Al Sayah, Fatima Wozniak, Lisa Rees, Sandra Soprovich, Allison Qiu, Weiyu Chik, Constance L. Chue, Pierre Florence, Peter Jacquier, Jennifer Lysak, Pauline Opgenorth, Andrea Katon, Wayne and Majumdar, Sumit R. 2014. Collaborative Care Versus Screening and Follow-up for Patients With Diabetes and Depressive Symptoms: Results of a Primary Care–Based Comparative Effectiveness Trial. Diabetes Care, Vol. 37, Issue. 12, p. 3220.
    Petersen, Juliana J. König, Jochem Paulitsch, Michael A. Mergenthal, Karola Rauck, Sandra Pagitz, Manuel Schmidt, Konrad Haase, Lydia Gerlach, Ferdinand M. and Gensichen, Jochen 2014. Long-term effects of a collaborative care intervention on process of care in family practices in Germany: a 24-month follow-up study of a cluster randomized controlled trial. General Hospital Psychiatry, Vol. 36, Issue. 6, p. 570.
    2013. Depression case management an attractive option in primary care. PharmacoEconomics & Outcomes News, Vol. 677, Issue. 1, p. 6.
    Sonntag, Michael König, Hans-Helmut and Konnopka, Alexander 2013. The Estimation of Utility Weights in Cost-Utility Analysis for Mental Disorders: A Systematic Review. PharmacoEconomics, Vol. 31, Issue. 12, p. 1131.
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Cost-effectiveness of depression case management in small practices

  • Jochen Gensichen (a1), Juliana J. Petersen (a2), Michael Von Korff (a3), Dirk Heider (a4), Steffen Baron (a2), Jochem König (a5), Antje Freytag (a6), Christian Krauth (a7), Ferdinand M. Gerlach (a2) and Hans-Helmut König (a8)...
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