Modelling the cost-effectiveness of pharmacotherapy compared with cognitive–behavioural therapy and combination therapy for the treatment of moderate to severe depression in the UK

摘要: Background. The National Institute of Health and Care Excellence (NICE) in England Wales recommends the combination pharmacotherapy psychotherapy for treatment moderate to severe depression. However, cost-effectiveness analysis on which these recommendations are based have not included as monotherapy a potential option. For this reason, we aimed update, augment refine existing economic evaluation. Methods. We constructed decision analytic model with 27-month time horizon. We compared cognitive behavioural therapy (CBT) depression secondary care from healthcare service perspective. reviewed literature identify relevant evidence and, where possible, synthesised clinical trials meta-analysis inform parameters. Results. The suggested that CBT was most likely be cost-effective option cost per QALY threshold above £22,000. It dominated had an incremental ratio £20,039 quality-adjusted life year pharmacotherapy. There significant uncertainty probabilistic deterministic sensitivity analyses. Conclusions. Contrary previous NICE guidance, results indicated even those patients whom is acceptable, may conclusion limited base, particularly treatment. In addition, cannot easily transferred primary setting.