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Sobocki, PatrikHealth economics of depressionFredagen den 13 oktober 2006, kl. 09.00. Karolinska Institutet, Nobels väg 15A, sal Lennart Nilsson. |
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| ISBN: 91-7140-897-5 | Diss: 06:237 |
Abstract:
A new approach was developed to assess the societal cost of depression in Europe. The results showed that more than 21 million Europeans are suffering from depression and that depression cost European society more than SEK 1000 billion per year, two-thirds of which are found outside the healthcare system. The cost of depression equals SEK 2 300 per inhabitant in Europe corresponding to 1% of the European national incomes.
Naturalistic studies of cost and outcome in clinical practice are rare. The study "Health Economics of Depression In Sweden" (HEADIS) is one of the first naturalistic observational studies conducted in Sweden, collecting information on the cost and quality of life related to patients treated for depression in primary care. The cost for a patient treated for a depressive episode was estimated at SEK 51000. Depressed patients were, on average, absent from work 1.5 months during six months, which constituted 65% of the total costs for depression. Depression causes a reduction in quality of life of 50% as compared to the general population, which is in the same range as after a severe stroke. Treatment significantly improved patients' quality of life measured with a standard generic quality of life instrument (EQ-5D). For patients who went into remission, we observed both statistically significant reductions in costs and improvements in quality of life of more than 40% as compared to non-remitting patients.
A computer simulation model was developed to project costs and benefits from alternative treatments for depression. The health economic data collected in the HEADIS study was used in the model. A simulation was performed with a hypothetical intervention over a five-year period. The results showed that a new treatment which increases the probability that the patient goes into remission, produced cost savings amounting to SEK 20 100 and a QALY gain of 0.07. The results underscore that the achievement of clinical remission is a key health economic parameter to reduce the burden of depression.
This thesis has contributed with new health economic data on the social cost of depression at an
international level, and patient-level data of costs and quality of life for depressed patients in a
primary care setting. Accurately estimating the impact of a disease, in terms of costs and quality
of life, is the first important step towards better priorities of resource allocation to reduce the
burden of the disease. This data is also an input in economic evaluations, which provides
information for allocation of resources between different types of treatments. Increased
research efforts are needed to provide the necessary effectiveness data in clinical practice, and
to make such studies relevant and credible as instruments for resource allocation in practice.
Keywords: depression, cost of illness, cost, quality of life, cost-effectiveness, modelling List of papers
Cost of depression in Europe
Sobocki P, Angst J, Jonsson B, Rehnberg C
Journal of Mental Health Policy and Economics,
2006;
9:
87-98
Resource-use and costs associated with patients treated for depression in primary care.
Sobocki P, Ekman M, Agren H, Runeson B, Krakau I, Martensson B, Jonsson B
European Journal of Health Economics,
2006
In Print
Health-related quality of life measured with EQ-5D in patients treated for depression in primary care
Sobocki P, Ekman M, Agren H, Runeson B, Krakau I, Martensson B, Jonsson B
Value in Health,
2006
In Print
The mission is remission: health economic consequences of achieving full remission with antidepressant treatment for depression
Sobocki P, Ekman M, Agren H, Runeson B, Jonsson B
Int J Clin Pract,
2006;
60(7):
791-8
Model to assess the cost-effectiveness of new treatments for depression
Sobocki P, Ekman M, Agren H, Jonsson B, Rehnberg C
Int J Technol Assess Health Care,
2006;
22(4):
469-77
