title: Cost-effectiveness of collaborative care for the treatment of major depressive disorder in primary care. A systematic review.
abstract: 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.
authors.affiliation: Netherlands Institute for Mental Health and Addiction (Trimbos-Institute), Utrecht, The Netherlands. Ksteenbergen@trimbos.nl
authors.forename: Kirsten M
authors.initials: KM
authors.lastname: van Steenbergen-Weijenburg
authors.forename: Christina M
authors.initials: CM
authors.lastname: van der Feltz-Cornelis
authors.forename: Eva K
authors.initials: EK
authors.lastname: Horn
authors.forename: Harm W J
authors.initials: HW
authors.lastname: van Marwijk
authors.forename: Aartjan T F
authors.initials: AT
authors.lastname: Beekman
authors.forename: Frans F H
authors.initials: FF
authors.lastname: Rutten
authors.forename: Leona
authors.initials: L
authors.lastname: Hakkaart-van Roijen
mesh_terms: D000328:Adult; D000368:Aged; D003299:Cooperative Behavior; D003362:Cost-Benefit Analysis; D003865:Major Depressive Disorder / Q000628:therapy*; D017048:Health Care Costs; D006801:Humans; D008875:Middle Aged; D011320:Primary Health Care / Q000191:economics* / Q000458:organization & administration; D019057:Quality-Adjusted Life Years