The online version of this article (10.1186/s12888-017-1577-7) contains supplementary material, which is available to authorized users.
Experience sampling, a method for real-time self-monitoring of affective experiences, holds opportunities for person-tailored treatment. By focussing on dynamic patterns of positive affect, experience sampling method interventions (ESM-I) accommodate strategies to enhance personalized treatment of depression―at potentially low-costs. This study aimed to investigate the cost-effectiveness of an experience sampling method intervention in patients with depression, from a societal perspective.
Participants were recruited between January 2010 and February 2012 from out-patient mental health care facilities in or near the Dutch cities of Eindhoven and Maastricht, and through local advertisements. Out-patients diagnosed with major depression (n = 101) receiving pharmacotherapy were randomized into: (i) ESM-I consisting of six weeks of ESM combined with weekly feedback regarding the individual’s positive affective experiences, (ii) six weeks of ESM without feedback, or (iii) treatment as usual only. Alongside this randomised controlled trial, an economic evaluation was conducted consisting of a cost-effectiveness and a cost-utility analysis, using Hamilton Depression Rating Scale (HDRS) and quality adjusted life years (QALYs) as outcome, with willingness-to-pay threshold for a QALY set at €50,000 (based on Dutch guidelines for moderate severe to severe illnesses).
The economic evaluation showed that ESM-I is an optimal strategy only when willingness to pay is around €3000 per unit HDRS and around €40,500 per QALY. ESM-I was the least favourable treatment when willingness to pay was lower than €30,000 per QALY. However, at the €50,000 willingness-to-pay threshold, ESM-I was, with a 46% probability, the most favourable treatment (base-case analysis). Sensitivity analyses confirmed the robustness of these results.
We may tentatively conclude that ESM-I is a cost-effective add-on intervention to pharmacotherapy in outpatients with major depression.
Netherlands Trial register, NTR1974.
Additional file 3: Table S1. Costs at baseline and costs over 32 weeks (intention-to-treat) per type of consultation. Table S2. Unit costs per cost category. Costs were obtained from a Dutch cost manual (2009-prices, Hakkaart van Roijen 2010) and calculated to their 2012 value (Statline). (DOCX 20 kb)
Additional file 4: Figure S1. Cost-effectiveness acceptability curve assessing HDRS, sensitivity analysis: GP costs based on psychiatric tariff. (DOCX 93 kb)
Additional file 5: Figure S2. Cost-effectiveness acceptability curve assessing HDRS, sensitivity analysis: health care perspective. (DOCX 94 kb)
Additional file 6: Figure S3. Cost-effectiveness acceptability curve assessing HDRS, sensitivity analysis: completers only. (DOCX 93 kb)
Additional file 7: Figure S4. Cost-effectiveness acceptability curve assessing HDRS, sensitivity analysis: unadjusted for baseline costs. (DOCX 95 kb)
Additional file 8: Figure S5. Cost-effectiveness acceptability curve, sensitivity analysis, assessing EQ-5D: Dutch valuation of the EQ-5D. (DOCX 96 kb)
Additional file 9: Figure S6. Cost-effectiveness acceptability curve, sensitivity analysis, assessing EQ-5D: GP costs based psychiatric tariff. (DOCX 92 kb)
Additional file 10: Figure S7. Cost-effectiveness acceptability curve, sensitivity analysis, assessing EQ-5D: health care perspective. (DOCX 96 kb)
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- Economic evaluation of an experience sampling method intervention in depression compared with treatment as usual using data from a randomized controlled trial
Claudia J. P. Simons
Ghislaine A. P. G. van Mastrigt
Jessica A. Hartmann
Jim van Os
- BioMed Central