| 1. |
- McCrone, Paul, et al.
(författare)
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Economic impact of reducing treatment gaps in depression
- 2023
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Ingår i: European Psychiatry. - 0924-9338. ; 66:1, s. e57-
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Tidskriftsartikel (refereegranskat)abstract
- Background Major depressive disorder (MDD) is highly prevalent across Europe. While evidence-based treatments exist, many people with MDD have their condition undetected and/or untreated. This study aimed to assess the cost-effectiveness of reducing treatment gaps using a modeling approach. Methods A decision-tree model covering a 27-month time horizon was used. This followed a care pathway where MDD could be detected or not, and where different forms of treatment could be provided. Expected costs pertaining to Germany, Hungary, Italy, Portugal, Sweden, and the UK were calculated and quality-adjusted life years (QALYs) were estimated. The incremental costs per QALY of reducing detection and treatment gaps were estimated. Results The expected costs with a detection gap of 69% and treatment gap of 50% were €1236 in Germany, €476 in Hungary, €1413 in Italy, €938 in Portugal, €2093 in Sweden, and €1496 in the UK. The incremental costs per QALY of reducing the detection gap to 50% ranged from €2429 in Hungary to €10,686 in Sweden. The figures for reducing the treatment gap to 25% ranged from €3146 in Hungary to €13,843 in Sweden. Conclusions Reducing detection and treatment gaps, and maintaining current patterns of care, is likely to increase healthcare costs in the short term. However, outcomes are improved, and reducing these gaps to 50 and 25%, respectively, appears to be a cost-effective use of resources.
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| 2. |
- Skokauskas, Norbert, et al.
(författare)
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The cost of child and adolescent mental health services
- 2018
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Ingår i: Lancet psychiatry. - 2215-0374 .- 2215-0366. ; 5, s. 299-300
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- More than 2·5 billion children and adolescents exist worldwide, with most individuals living in low-income and middle-income countries (LMICs).1 For these children and adolescents, mental health and neurodevelopmental disorders remain one of the leading causes of the global burden of disease and years lived with disability.2 Although the importance of child and adolescent mental health (CAMH) has been widely acknowledged by organisations such as the UN,3 the development of an inclusive cross-sectorial mental health system for children and adolescents has not gained adequate traction.
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| 3. |
- Strawbridge, Rebecca, et al.
(författare)
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Care pathways for people with major depressive disorder : A European Brain Council Value of Treatment study
- 2022
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Ingår i: European Psychiatry. - : Royal College of Psychiatrists. - 0924-9338 .- 1778-3585. ; 65:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Despite well-established guidelines for managing major depressive disorder, its extensive disability burden persists. This Value of Treatment mission from the European Brain Council aimed to elucidate the nature and extent of gaps between best-practice and current-practice care, specifically to: 1. Identify current treatment gaps along the care pathway and determine the extent of these gaps in comparison with the stepped-care model and 2. Recommend policies intending to better meet patient needs (i.e., minimize treatment gaps). Methods After agreement upon a set of relevant treatment gaps, data pertaining to each gap were gathered and synthesized from several sources across six European countries. Subsequently, a modified Delphi approach was undertaken to attain consensus among an expert panel on proposed recommendations for minimizing treatment gaps. Results Four recommendations were made to increase the depression diagnosis rate (from ∼50% episodes), aiming to both increase the number of patients seeking help, and the likelihood of a practitioner to correctly detect depression. These should reduce time to treatment (from ∼1 to ∼8Â years after illness onset) and increase rates of treatment; nine further recommendations aimed to increase rates of treatment (from ∼25 to ∼50% of patients currently treated), mainly focused on targeting the best treatment to each patient. To improve follow-up after treatment initiation (from ∼30 to ∼65% followed up within 3Af; months), seven recommendations focused on increasing continuity of care. For those not responding, 10 recommendations focused on ensuring access to more specialist care (currently at rates of ∼5-25% of patients). Conclusions The treatment gaps in depression care are substantial and concerning, from the proportion of people not entering care pathways to those stagnating in primary care with impairing and persistent illness. A wide range of recommendations can be made to enhance care throughout the pathway.
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| 4. |
- Vataire, Anne-Lise, et al.
(författare)
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Core discrete event simulation model for the evaluation of health care technologies in major depressive disorder.
- 2014
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Ingår i: Value in Health. - : Elsevier BV. - 1098-3015. ; 17:2, s. 183-195
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Tidskriftsartikel (refereegranskat)abstract
- A review of existing economic models in major depressive disorder (MDD) highlighted the need for models with longer time horizons that also account for heterogeneity in treatment pathways between patients. A core discrete event simulation model was developed to estimate health and cost outcomes associated with alternative treatment strategies.
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