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Cost-effectiveness of In-Home Cognitive Behavioral Therapy for low-income depressed mothers participating in early childhood prevention programs
- Source :
- Journal of Affective Disorders. 208:475-482
- Publication Year :
- 2017
- Publisher :
- Elsevier BV, 2017.
-
Abstract
- Background To determine the cost-effectiveness of In-Home Cognitive Behavioral Therapy (IH-CBT) for low-income mothers enrolled in a home visiting program. Methods A cost-utility analysis was conducted using results from a clinical trial of IH-CBT and standard of care for depression derived from the literature. A probabilistic, patient-level Markov model was developed to determine Quality Adjusted Life Years (QALYs). Costs were determined using the Medical Expenditure Panel Survey. A three-year time horizon and payer perspective were used. Sensitivity analyses were employed to determine robustness of the model. Results IH-CBT was cost-effective relative to standard of care. IH-CBT was expected to be cost-effective at a three-year time horizon 99.5%, 99.7%, and 99.9% of the time for willingness-to-pay thresholds of US$25,000, US$50,000, and US$100,000, respectively. Patterns were upheld at one-year and five-year time horizons. Over the three-year time horizon, mothers receiving IH-CBT were expected to have 345.6 fewer days of depression relative to those receiving standard home visiting and treatment in the community. Conclusions IH-CBT is a more cost-effective treatment for low-income, depressed mothers than current standards of practice. These findings add to the growing literature demonstrating the cost-effectiveness of CBT for depression, and expand it to cover new mothers. From a payer perspective, IH-CBT is a sound option for treatment of depressed, low-income mothers. Limitations include a restricted time horizon and estimating of standard of care costs.
- Subjects :
- Adult
Gerontology
medicine.medical_specialty
Adolescent
Cost effectiveness
Cost-Benefit Analysis
medicine.medical_treatment
Mothers
Time horizon
Article
Young Adult
03 medical and health sciences
0302 clinical medicine
Pregnancy
Early Intervention, Educational
medicine
Humans
030212 general & internal medicine
Early childhood
Child
Psychiatry
Poverty
health care economics and organizations
Depression (differential diagnoses)
Depressive Disorder, Major
Cognitive Behavioral Therapy
Depression
Home Care Services
030227 psychiatry
Quality-adjusted life year
House Calls
Cognitive behavioral therapy
Psychiatry and Mental health
Clinical Psychology
Cognitive processing therapy
Female
Quality-Adjusted Life Years
Psychology
Medical Expenditure Panel Survey
Subjects
Details
- ISSN :
- 01650327
- Volume :
- 208
- Database :
- OpenAIRE
- Journal :
- Journal of Affective Disorders
- Accession number :
- edsair.doi.dedup.....5571c9fddd7174354814a78879d827cc