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Cost-effectiveness of family psychoeducation to prevent relapse in major depression: results from a randomized controlled trial.

Shimodera S, Furukawa TA, Mino Y, Shimazu K, Nishida A, Inoue S - BMC Psychiatry (2012)

Bottom Line: This cost-effectiveness finding was robust when the price for family psychoeducation ranged between 50% to 150% of the baseline scenario in sensitivity analyses.If a relapse-free day is considered to be worth $30 or more, all the pricing scenarios have a close to 100% probability of being cost-effective.UMIN-CTR (UMIN000005555).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neuropsychiatry, Kochi Medical School, Kohatsu, Kochi 783-8505, Japan.

ABSTRACT

Background: Family psychoeducation is a relatively simple and straightforward intervention whose prophylactic effectiveness and cost-effectiveness is well-established for schizophrenia. We have recently demonstrated its effectiveness for unipolar depression, but its cost-effectiveness has never been examined. We hereby report a cost-effectiveness analysis alongside a randomized controlled trial in order to assess its cost-effectiveness for preventing relapse/recurrence in depression.

Methods: Fifty-seven patients diagnosed with major depression and undergoing its maintenance treatment, and their primary family members were randomized to treatment as usual (TAU) only or to TAU plus family psychoeducation, which consisted of four 2-hour multiple-family sessions consisting of didactic lectures about depression (30 minutes) and group discussion and problem solving (60-90 minutes). The economic analyses were undertaken from the perspective of the National Health Insurance (NHI), assuming the most reasonable price of US$50 per psychoeducation session per patient. The main outcome measures included relapse-free days and direct costs to the NHI.

Results: The intervention group enjoyed 272 (SD: 7.1) relapse-free days, while the control group spent 214 (SD: 90.8) relapse-free days (Cox proportional hazard ratio=0.17, 95%CI: 0.04 to 0.75, p=0.002). Cost-effectiveness acceptability curves suggested that the family psychoeducation has 90% or more chances of being cost-effective if the decision-maker is prepared to pay US$20 for one additional relapse-free day. This cost-effectiveness finding was robust when the price for family psychoeducation ranged between 50% to 150% of the baseline scenario in sensitivity analyses. If a relapse-free day is considered to be worth $30 or more, all the pricing scenarios have a close to 100% probability of being cost-effective.

Conclusion: Family psychoeducation is effective in the relapse prevention of depression and is highly likely to be cost-effective if a relapse-free day is valued as US$20 or more.

Trial registration: UMIN-CTR (UMIN000005555).

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Related in: MedlinePlus

Cost-effectiveness acceptability curves showing the probability that the treatment program is cost-effective in comparison with TAU (y-axis), as a function of a decision-maker’s ceiling cost-effectiveness value for one relapse-free day (x-axis), when the family psychoeducation session is priced at US$ 25, $50 or $75.
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Figure 1: Cost-effectiveness acceptability curves showing the probability that the treatment program is cost-effective in comparison with TAU (y-axis), as a function of a decision-maker’s ceiling cost-effectiveness value for one relapse-free day (x-axis), when the family psychoeducation session is priced at US$ 25, $50 or $75.

Mentions: Figure 1 presents the CEACs for family psychoeducation plus TAU over TAU alone under the three scenarios pricing attendance at a psychoeducation session at US$25, US$50 or US$75. The curve indicates the probability for the addition of family psychoeducation to be cost-effective for a range of potential maximum amounts (ceiling ratio) that a decision-maker is willing to pay for one more relapse-free day.


Cost-effectiveness of family psychoeducation to prevent relapse in major depression: results from a randomized controlled trial.

Shimodera S, Furukawa TA, Mino Y, Shimazu K, Nishida A, Inoue S - BMC Psychiatry (2012)

Cost-effectiveness acceptability curves showing the probability that the treatment program is cost-effective in comparison with TAU (y-axis), as a function of a decision-maker’s ceiling cost-effectiveness value for one relapse-free day (x-axis), when the family psychoeducation session is priced at US$ 25, $50 or $75.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3473266&req=5

Figure 1: Cost-effectiveness acceptability curves showing the probability that the treatment program is cost-effective in comparison with TAU (y-axis), as a function of a decision-maker’s ceiling cost-effectiveness value for one relapse-free day (x-axis), when the family psychoeducation session is priced at US$ 25, $50 or $75.
Mentions: Figure 1 presents the CEACs for family psychoeducation plus TAU over TAU alone under the three scenarios pricing attendance at a psychoeducation session at US$25, US$50 or US$75. The curve indicates the probability for the addition of family psychoeducation to be cost-effective for a range of potential maximum amounts (ceiling ratio) that a decision-maker is willing to pay for one more relapse-free day.

Bottom Line: This cost-effectiveness finding was robust when the price for family psychoeducation ranged between 50% to 150% of the baseline scenario in sensitivity analyses.If a relapse-free day is considered to be worth $30 or more, all the pricing scenarios have a close to 100% probability of being cost-effective.UMIN-CTR (UMIN000005555).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neuropsychiatry, Kochi Medical School, Kohatsu, Kochi 783-8505, Japan.

ABSTRACT

Background: Family psychoeducation is a relatively simple and straightforward intervention whose prophylactic effectiveness and cost-effectiveness is well-established for schizophrenia. We have recently demonstrated its effectiveness for unipolar depression, but its cost-effectiveness has never been examined. We hereby report a cost-effectiveness analysis alongside a randomized controlled trial in order to assess its cost-effectiveness for preventing relapse/recurrence in depression.

Methods: Fifty-seven patients diagnosed with major depression and undergoing its maintenance treatment, and their primary family members were randomized to treatment as usual (TAU) only or to TAU plus family psychoeducation, which consisted of four 2-hour multiple-family sessions consisting of didactic lectures about depression (30 minutes) and group discussion and problem solving (60-90 minutes). The economic analyses were undertaken from the perspective of the National Health Insurance (NHI), assuming the most reasonable price of US$50 per psychoeducation session per patient. The main outcome measures included relapse-free days and direct costs to the NHI.

Results: The intervention group enjoyed 272 (SD: 7.1) relapse-free days, while the control group spent 214 (SD: 90.8) relapse-free days (Cox proportional hazard ratio=0.17, 95%CI: 0.04 to 0.75, p=0.002). Cost-effectiveness acceptability curves suggested that the family psychoeducation has 90% or more chances of being cost-effective if the decision-maker is prepared to pay US$20 for one additional relapse-free day. This cost-effectiveness finding was robust when the price for family psychoeducation ranged between 50% to 150% of the baseline scenario in sensitivity analyses. If a relapse-free day is considered to be worth $30 or more, all the pricing scenarios have a close to 100% probability of being cost-effective.

Conclusion: Family psychoeducation is effective in the relapse prevention of depression and is highly likely to be cost-effective if a relapse-free day is valued as US$20 or more.

Trial registration: UMIN-CTR (UMIN000005555).

Show MeSH
Related in: MedlinePlus