Cost-effectiveness of collaborative care for the treatment of major depressive disorder in primary care. A systematic review

BMC Health Serv Res. 2010 Jan 19:10:19. doi: 10.1186/1472-6963-10-19.


Background: The effectiveness of collaborative care for patients with major depressive disorder in primary care has been established. Assessing its cost-effectiveness is important for deciding on implementation. This review therefore evaluates the cost-effectiveness of collaborative care for major depressive disorder in primary care.

Methods: A systematic search on economic evaluations of collaborative care was conducted in Pubmed and PsychInfo. Quality of the studies was measured with the Cochrane checklist and the CHEC-list for economic evaluations. Cost-effectiveness and costs per depression-free days were reported.

Results: 8 studies were found, involving 4868 patients. The quality of the cost effectiveness studies, according to the CHEC-list, could be improved. Generally, the studies did not include all relevant costs and did not perform sensitivity analysis. Only 4 out of 8 studies reported cost per QALY, 6 out of 8 reported costs per depression-free days. The highest costs per QALY reported were $49,500, the highest costs per depression-free day were $24.

Conclusions: Although studies did not fulfil all criteria of the CHEC-list, collaborative care is a promising intervention and it may be cost-effective. However, to conclude on the cost-effectiveness, depression research should follow economic guidelines to improve the quality of the economic evaluations.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • Cooperative Behavior*
  • Cost-Benefit Analysis
  • Depressive Disorder, Major / therapy*
  • Health Care Costs*
  • Humans
  • Middle Aged
  • Primary Health Care / economics*
  • Primary Health Care / organization & administration
  • Quality-Adjusted Life Years