Relative Cost-Effectiveness of Treatments for Adolescent Depression: 36-Week Results From the TADS Randomized Trial

摘要: Objective: The cost-effectiveness of three active interventions for major depression in adolescents was compared after 36 weeks treatment the Treatment Adolescents with Depression Study. Method: Outpatients aged 12 to 18 years a primary diagnosis participated randomized controlled trial conducted at 13 U.S. academic and community clinics from 2000 2004. Three hundred twenty-seven participants 1 3 arms, fluoxetine alone (n = 109), cognitive-behavioral therapy 111) alone, or their combination 107), were evaluated 3-month acute 6-month continuation/maintenance period. Costs services received estimated examined relation number depression-free days quality-adjusted life-years. Costeffectiveness acceptability curves also generated. Sensitivity analyses assess differences on life-years measures. Results: Cognitive-behavioral most costly component (mean $1,787 [in monotherapy] $1,833 therapy], median $1,923 [for both]). Reflecting higher direct indirect costs associated psychiatric hospital use, outside Study fluoxetine-treated patients $5,382, $2,341) significantly than those treated $3,102, $1,373) $2,705, $927). Accordingly, indicate that is highly likely (990%) be more cost-effective weeks. not fluoxetine. Conclusions: These findings support use over monotherapy. J. Am. Acad. Child Adolesc. Psychiatry, 2009;48(7):711Y720. Key Words: depression, cost-effectiveness, therapy, antidepressants. Clinical registration informationVTreatment With (TADS). URL: http://clinicaltrials.gov. Unique identifier: NCT00006286.