Cost-effectiveness analysis and cost-utility analysis of a model of integrated mental health video consultations (PROVIDE-C randomised controlled trial) for people with depression and anxiety.

BACKGROUND

We conducted a health economic evaluation alongside the PROVIDE-C randomised controlled trial which analysed the effectiveness of a model of integrated mental health video consultations for people with depression and anxiety in primary care in Germany in comparison to treatment as usual (TAU).

METHODS

A cost-effectiveness (CEA) and cost-utility analysis (CUA) were performed six and twelve months after baseline from a societal perspective. Bootstrap procedure was applied and for each bootstrap replication, multiple imputation was conducted, and incremental costs and effects were estimated using generalised linear models.

RESULTS

In total 376 participants (18 to 81 years) with depression and/or anxiety were included in the analysis. We found that €3662 would be required for an additional person who experienced a clinically minimum important reduction of 5 points at the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) and €1622 would be required for an additional person with a PHQ-ADS score below 10 points (persons with not more than mild symptom severity) six months after baseline. At twelve months after baseline, PROVIDE-C was dominant compared to TAU. While 6 months after baseline the probability of cost-effectiveness was approximately 36%, 40% and 56% in terms of quality adjusted life years (QALYs) for the respective willingness-to-pay threshold of €0, €20,000, and €100,000, at 12 months after baseline the respective probabilities of cost-effectiveness increased to approximately 71%, 78%, and 86%.

CONCLUSIONS

While the PROVIDE-C intervention is less likely cost-effective 6 months after baseline, it was likely cost-effective 12 months after baseline.