People undergoing telephone depression program may have to cough up a moderate increase in health care costs, researchers at Group Health Research Institute, Seattle said.
The researchers found that patients who participated in a structured telephone program to manage their depression appeared to experience significant benefits and only a moderate increase in health care costs when compared with those who receive usual care.
Organized treatment programs for depression in primary care have been proven effective across a wide range of patient populations and health care systems, according to the study.
"Broad implementation of improved depression care programs will depend on the balance of benefits and added costs. Depression has large economic effects outside the health care system, including disability, lost work productivity, reduced educational attainment and relationship disruption. Ideally, decisions about the value of depression care programs should consider these broader economic effects," Science Daily quoted the authors as saying.
Dr. Gregory E. Simon and his colleagues conducted a randomised trial comparing two depression care programs with continued usual care.
Telephone assessments were conducted periodically over 24 months, and costs were measured using health plan accounting records.
Over the 24-month study, the telephone care management program led to an average gain of 29 depression-free days and a 676 dollars increase in outpatient health care costs compared with usual care.
Care management plus psychotherapy led to a gain of 46 depression-free days at a cost of 397 dollars.
"Willingness to pay for time free of depression is a simple (albeit far from perfect) method for summarizing various economic benefits of improved depression care. Our previous research suggests that primary care patients treated for depression are on average willing to pay approximately 10 dollars (in 2000 U.S. dollars) for an additional day free of depression," wrote the authors.
"In the current study, telephone care management alone had a negative net benefit even if the cost of a depression-free day was placed at 20 dollars; however, the telephone care management plus psychotherapy program delivered a positive benefit if a depression-free day was valued at 9 dollars or more.
"The primary goal of depression treatment is to relieve suffering and improve function, not to decrease health care costs. We certainly do not intend to imply that depression treatment is justified only if it is either cost neutral or cost saving. Our findings do, however, offer some guidance to insurers or health care systems considering efforts to improve care for depression.
"The balance of added benefits and added costs was more favorable for the more intensive program. Efforts to improve depression treatment in primary care should consider incorporating structured psychotherapy interventions," the authors concluded.
The study has been published in the October issue of Archives of General Psychiatry.