Economic evaluation of the Target-D platform to match depression management to severity prognosis in primary care: A within-trial costutility analysis

Yong Yi Lee, Cathrine Mihalopoulos, Mary Lou Chatterton, Susan L. Fletcher, Patty Chondros, Konstancja Densley, Elizabeth Murray, Christopher Dowrick, Amy Coe, Kelsey L. Hegarty, Sandra K. Davidson, Caroline Wachtler, Victoria J. Palmer, Jane M. Gunn

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Abstract

Background Target-D, a new person-centred e-health platform matching depression care to symptom severity prognosis (minimal/mild, moderate or severe) has demonstrated greater improvement in depressive symptoms than usual care plus attention control. The aim of this study was to evaluate the cost-effectiveness of Target-D compared to usual care from a health sector and partial societal perspective across 3-month and 12-month follow-up. Methods and findings A cost-utility analysis was conducted alongside the Target-D randomised controlled trial; which involved 1,868 participants attending 14 general practices in metropolitan Melbourne, Australia. Data on costs were collected using a resource use questionnaire administered concurrently with all other outcome measures at baseline, 3-month and 12-month follow-up. Intervention costs were assessed using financial records compiled during the trial. All costs were expressed in Australian dollars (A$) for the 2018-19 financial year. QALY outcomes were derived using the Assessment of Quality of Life-8D (AQoL-8D) questionnaire. On a per person basis, the Target-D intervention cost between $14 (minimal/mild prognostic group) and $676 (severe group). Health sector and societal costs were not significantly different between trial arms at both 3 and 12 months. Relative to a A$50,000 per QALY willingness- to-pay threshold, the probability of Target-D being cost-effective under a health sector Conclusions Target-D is likely to represent good value for money for health care decision makers. Further evaluation of QALY outcomes should accompany any routine roll-out to assess comparability of results to those observed in the trial. This trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12616000537459).

Original languageEnglish
Article numbere0268948
Number of pages14
JournalPLoS ONE
Volume17
Issue number5 May
DOIs
Publication statusPublished - May 2022

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