title: [Hospital production cost of repetitive transcranial magnetic stimulation (rTMS) in the treatment of depression].
abstract: BACKGROUND
  Repetitive transcranial magnetic stimulation (rTMS) is an effective and well-tolerated treatment in resistant depression with mild to moderate intensity. This indication has not yet been approved in France. The cost and medico-economic value of rTMS in psychiatry remains unknown. The aim of this preliminary study was to assess rTMS cost production analysis as an in-hospital treatment for depression.
  
  
  METHODS
  The methodology, derived from analytical accounts, was validated by a multidisciplinary task force (clinicians, public health doctors, pharmacists, administrative officials and health economist). It was pragmatic, based on official and institutional documentary sources and from field practice. It included equipment, staff, and structure costs, to get an estimate as close to reality as possible. First, we estimated the production cost of rTMS session, based on our annual activity. We then estimated the cost of a cure, which includes 15 sessions. A sensitivity analysis was also performed.
  
  
  RESULTS
  The hospital production cost of a cure for treating depression was estimated at € 1932.94 (€ 503.55 for equipment, € 1082.75 for the staff, and € 346.65 for structural expenses).
  
  
  CONCLUSIONS
  This cost-estimate has resulted from an innovative, pragmatic, and cooperative approach. It is slightly higher but more comprehensive than the costs estimated by the few international studies. However, it is limited due to structure-specific problems and activity. This work could be repeated in other circumstances in order to obtain a more general estimate, potentially helpful for determining an official price for the French health care system. Moreover, budgetary constraints and public health choices should be taken into consideration.
authors.affiliation: Service de pharmacologie clinique, CEIP-A, CHU de Nantes, 9, quai Moncousu, 44093 Nantes, France. Electronic address: francoisetxe@yahoo.fr.
authors.forename: F
authors.initials: F
authors.lastname: Etcheverrigaray
authors.affiliation: Unité ECT-TMS, CAPPA Jacques-Prévert, service d'addictologie et de psychiatrie de liaison, CHU de Nantes, 44093 Nantes, France.
authors.forename: S
authors.initials: S
authors.lastname: Bulteau
authors.affiliation: Pôle offre de soins, direction de la plate-forme de proximité 3 « urgences médecine soins critiques-psychiatrie et santé mentale », CHU de Nantes, 44093 Nantes, France.
authors.forename: L O
authors.initials: LO
authors.lastname: Machon
authors.affiliation: Cellule innovation, direction de la recherche, CHU de Nantes, 44093 Nantes, France.
authors.forename: V P
authors.initials: VP
authors.lastname: Riche
authors.affiliation: Service d'information médicale, CHU de Nantes, 44093 Nantes, France.
authors.forename: N
authors.initials: N
authors.lastname: Mauduit
authors.affiliation: Direction des affaires financières et du contrôle de gestion, CHU de Nantes, 44093 Nantes, France.
authors.forename: R
authors.initials: R
authors.lastname: Tricot
authors.affiliation: Pharmacie centrale, hôpital Saint-Jacques, CHU de Nantes, 44093 Nantes, France.
authors.forename: O
authors.initials: O
authors.lastname: Sellal
authors.affiliation: Unité ECT-TMS, CAPPA Jacques-Prévert, service d'addictologie et de psychiatrie de liaison, CHU de Nantes, 44093 Nantes, France.
authors.forename: A
authors.initials: A
authors.lastname: Sauvaget
mesh_terms: D003365:Costs and Cost Analysis; D003863:Depression / Q000191:economics / Q000628:therapy*; D005602:France; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006761:Hospitals; D006801:Humans; D050781:Transcranial Magnetic Stimulation / Q000191:economics*
keywords: Cost production; Coût de production; Depression; Dépression; Psychiatrie; Psychiatry; rTMS