Cost-effectiveness of an intervention to prevent depression in at-risk teens

Arch Gen Psychiatry. 2005 Nov;62(11):1241-8. doi: 10.1001/archpsyc.62.11.1241.


Contact: Depression is common in adolescent offspring of depressed parents and can be prevented, but adoption of prevention programs is dependent on the balance of their incremental costs and benefits.

Objective: To examine the incremental cost-effectiveness of a group cognitive behavioral intervention to prevent depression in adolescent offspring of depressed parents.

Design: Cost-effectiveness analysis of a recent randomized controlled trial.

Setting: Kaiser Permanente Northwest, a large health maintenance organization.

Participants: Teens 13 to 18 years old at risk for depression.

Interventions: Usual care (n = 49) or usual care plus a 15-session group cognitive therapy prevention program (n = 45).

Main outcome measures: Clinical outcomes were converted to depression-free days and quality-adjusted life-years. Total health maintenance organization costs, costs of services received in other sectors, and family costs were combined with clinical outcomes in a cost-effectiveness analysis comparing the intervention with usual care for 1 year after the intervention.

Results: Average cost of the intervention was $1632, and total direct and indirect costs increased by $610 in the intervention group. However, the result was not statistically significant, suggesting a possible cost offset. Estimated incremental cost per depression-free day in the base-case analysis was $10 (95% confidence interval, -$13 to $52) or $9275 per quality-adjusted life-year (95% confidence interval, -$12 148 to $45 641).

Conclusions: Societal cost-effectiveness of a brief prevention program to reduce the risk of depression in offspring of depressed parents is comparable to that of accepted depression treatments, and the program is cost-effective compared with other health interventions commonly covered in insurance contracts.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Age Factors
  • Cognitive Behavioral Therapy / economics*
  • Cognitive Behavioral Therapy / methods*
  • Cost-Benefit Analysis
  • Depressive Disorder / economics
  • Depressive Disorder / prevention & control*
  • Depressive Disorder / therapy*
  • Female
  • Health Care Costs
  • Health Maintenance Organizations / economics
  • Humans
  • Male
  • Risk Factors
  • Treatment Outcome