Long-Term Depression Management is Cost-Effective, Study Shows

One of a cluster of five papers on depression in this issue of Annals, this study provides the first evidence that
depression disease management produces increasingly better outcomes over time, while at the same time becoming less costly.



For the study, practices providing enhanced care management supplemented acute care with systematic monitoring for two years,
encouraging depressed patients to engage in active treatment and using practice nurses to provide regular care management.



Analyzing the outcomes for 221 adults beginning treatment for major depression, the authors found that enhanced care
significantly increased the number of days free of depression impairment for two years when compared to usual care (623 days
vs. 527 days). The incremental cost-effectiveness ratio for enhanced care ranged from $5,054 to $8,073 per quality-adjusted
life year.


In their analysis, the authors point out that incremental quality-adjusted life years significantly increased with time while
incremental costs declined. They conclude that enhanced management of depression in primary care is cost-effective and
appears to be an efficient use of health care resources, and they assert that their findings should encourage health plans to
provide for long- rather than short-term depression management.


They note that primary care depression management results in comparable or greater cost-effectiveness than smoking cessation
counseling, hypertension treatment, cholesterol treatment or chronic obstructive pulmonary disease rehabilitation.


Cost-Effectiveness of Enhancing Primary Care Depression Management on an Ongoing Basis

By Kathryn Rost, Ph.D., et al


Angela Lower - aloweraafp

American Academy of Family Physicians


January/February Annals of Family Medicine tip sheet


Annals of Family Medicine is a peer-reviewed research journal that provides a cross-disciplinary forum for new,
evidence-based information affecting the primary care discipline. Launched in May 2003, the journal is sponsored by six
family medical organizations, including the American Academy of Family Physicians, the American Board of Family Practice, the
Society of Teachers of Family Medicine, the Association of Departments of Family Medicine, the Association of Family Practice
Residency Directors and the North American Primary Care Research Group. The journal is published six times each year and
contains original research from the clinical, biomedical, social and health services areas, as well as contributions on
methodology and theory, selected reviews, essays and editorials. A board of directors with representatives from each of the
sponsoring organizations oversees Annals. Complete editorial content and interactive discussion groups can be accessed free
of charge on the journal's Web site, American Academy of Family
Physicians.