Within-trial economic evaluation of diabetes-specific cognitive behaviour therapy in patients with type 2 diabetes and subthreshold depression.
BACKGROUND
Despite the high prevalence of subthreshold depression in patients with type 2 diabetes, evidence on cost-effectiveness of different therapy options for these patients is currently lacking.


METHODS
Within-trial economic evaluation of the diabetes-specific cognitive behaviour therapy for subthreshold depression. Patients with diabetes and subthreshold depression are randomly assigned to either 2 weeks of diabetes-specific cognitive behaviour group therapy (n = 104) or to standard diabetes education programme only (n = 104). Patients are followed for 12 months. During this period data on total health sector costs, patient costs and societal productivity costs are collected in addition to clinical data. Health related quality of life (the SF-36 and the EQ-5D) is measured at baseline, immediately after the intervention, at 6 and at 12 months after the intervention. Quality adjusted life years (QALYs), and cumulative costs will be estimated for each arm of the trial. Cost-effectiveness of the diabetes-specific cognitive behaviour group therapy will be analysed from the perspective of the German statutory health insurance and from the societal perspective. To this end, incremental cost-effectiveness ratio (ICER) in terms of cost per QALY gained will be calculated.


CONCLUSIONS
Some methodological issues of the described economic evaluation are discussed.


BACKGROUND
The trial has been registered at the Clinical Trials Register (NCT01009138).
Department of Public Health, Center of Health and Society, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany. nadja.chernyak@ddz.uni-duesseldorf.de
Nadja
N
Chernyak
Bernd
B
Kulzer
Norbert
N
Hermanns
Andreas
A
Schmitt
Annika
A
Gahr
Thomas
T
Haak
Johannes
J
Kruse
Christian
C
Ohmann
Marsel
M
Scheer
Guido
G
Giani
Andrea
A
Icks
D000293:Adolescent; D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000191:economics*; D003365:Costs and Cost Analysis; D003863:Depression / Q000503:physiopathology / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology*; D005858:Germany; D006801:Humans; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D019057:Quality-Adjusted Life Years; D011795:Surveys and Questionnaires; D055815:Young Adult