Considering the societal perspective in economic evaluations: a systematic review in the case of depression.
CUA
Cost-utility analysis
Depression
Direct costs
ICUR
Incremental cost-utility ratio
Indirect costs
QALY
Quality-adjusted life years
Societal perspective
Journal
Health economics review
ISSN: 2191-1991
Titre abrégé: Health Econ Rev
Pays: Germany
ID NLM: 101583209
Informations de publication
Date de publication:
22 Sep 2020
22 Sep 2020
Historique:
received:
06
07
2020
accepted:
07
09
2020
entrez:
23
9
2020
pubmed:
24
9
2020
medline:
24
9
2020
Statut:
epublish
Résumé
Depressive disorders are associated with a high burden of disease. However, due to the burden posed by the disease on not only the sufferers, but also on their relatives, there is an ongoing debate about which costs to include and, hence, which perspective should be applied. Therefore, the aim of this paper was to examine whether the change between healthcare payer and societal perspective leads to different conclusions of cost-utility analyses in the case of depression. A systematic literature search was conducted to identify economic evaluations of interventions in depression, launched on Medline and the Cost-Effectiveness Registry of the Tufts University using a ten-year time horizon (2008-2018). In a two-stepped screening process, cost-utility studies were selected by means of specified inclusion and exclusion criteria. Subsequently, relevant findings was extracted and, if not fully stated, calculated by the authors of this work. Overall, 53 articles with 92 complete economic evaluations, reporting costs from healthcare payer/provider and societal perspective, were identified. More precisely, 22 estimations (24%) changed their results regarding the cost-effectiveness quadrant when the societal perspective was included. Furthermore, 5% of the ICURs resulted in cost-effectiveness regarding the chosen threshold (2% of them became dominant) when societal costs were included. However, another four estimations (4%) showed the opposite result: these interventions were no longer cost-effective after the inclusion of societal costs. Summarising the disparities in results and applied methods, the results show that societal costs might alter the conclusions in cost-utility analyses. Hence, the relevance of the perspectives chosen should be taken into account when carrying out an economic evaluation. This systematic review demonstrates that the results of economic evaluations can be affected by different methods available for estimating non-healthcare costs.
Sections du résumé
BACKGROUND
BACKGROUND
Depressive disorders are associated with a high burden of disease. However, due to the burden posed by the disease on not only the sufferers, but also on their relatives, there is an ongoing debate about which costs to include and, hence, which perspective should be applied. Therefore, the aim of this paper was to examine whether the change between healthcare payer and societal perspective leads to different conclusions of cost-utility analyses in the case of depression.
METHODS
METHODS
A systematic literature search was conducted to identify economic evaluations of interventions in depression, launched on Medline and the Cost-Effectiveness Registry of the Tufts University using a ten-year time horizon (2008-2018). In a two-stepped screening process, cost-utility studies were selected by means of specified inclusion and exclusion criteria. Subsequently, relevant findings was extracted and, if not fully stated, calculated by the authors of this work.
RESULTS
RESULTS
Overall, 53 articles with 92 complete economic evaluations, reporting costs from healthcare payer/provider and societal perspective, were identified. More precisely, 22 estimations (24%) changed their results regarding the cost-effectiveness quadrant when the societal perspective was included. Furthermore, 5% of the ICURs resulted in cost-effectiveness regarding the chosen threshold (2% of them became dominant) when societal costs were included. However, another four estimations (4%) showed the opposite result: these interventions were no longer cost-effective after the inclusion of societal costs.
CONCLUSIONS
CONCLUSIONS
Summarising the disparities in results and applied methods, the results show that societal costs might alter the conclusions in cost-utility analyses. Hence, the relevance of the perspectives chosen should be taken into account when carrying out an economic evaluation. This systematic review demonstrates that the results of economic evaluations can be affected by different methods available for estimating non-healthcare costs.
Identifiants
pubmed: 32964372
doi: 10.1186/s13561-020-00288-7
pii: 10.1186/s13561-020-00288-7
pmc: PMC7510122
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
32Subventions
Organisme : H2020 European Research Council
ID : 779312
Références
J Manag Care Spec Pharm. 2018 Aug;24(8):726-734
pubmed: 30058980
Health Econ. 2009 Jun;18(6):629-43
pubmed: 18677724
PLoS One. 2017 Feb 27;12(2):e0172741
pubmed: 28241025
Expert Rev Pharmacoecon Outcomes Res. 2016 Oct;16(5):629-638
pubmed: 26641142
Value Health. 2014 Mar;17(2):183-95
pubmed: 24636376
Int J Technol Assess Health Care. 2017 Jan;33(2):251-260
pubmed: 28641592
Pharmacoeconomics. 2014 May;32(5):479-93
pubmed: 24554474
J Eval Clin Pract. 2009 Feb;15(1):195-203
pubmed: 19239602
Med Care. 2005 Jul;43(7 Suppl):5-14
pubmed: 16056003
BMC Health Serv Res. 2013 May 10;13:173
pubmed: 23663281
Health Technol Assess. 2013 Feb;17(7):1-166
pubmed: 23438937
Health Technol Assess. 2016 Feb;20(14):1-192
pubmed: 26910256
J Affect Disord. 2017 Aug 1;217:252-259
pubmed: 28437762
PLoS One. 2013 Aug 12;8(8):e70588
pubmed: 23950967
Pharmacoeconomics. 2019 Apr;37(4):461-473
pubmed: 30953263
Health Technol Assess. 2017 Aug;21(46):1-366
pubmed: 28857042
Health Technol Assess. 2014 May;18(31):1-167, vii-viii
pubmed: 24824481
J Med Econ. 2010;13(3):516-26
pubmed: 20698748
Blood. 2015 Mar 19;125(12):1866-9
pubmed: 25655601
BMC Med. 2018 Feb 23;16(1):28
pubmed: 29471877
Psychiatr Serv. 2017 Sep 1;68(9):899-906
pubmed: 28502247
Pharmacoeconomics. 2019 Apr;37(4):621-623
pubmed: 30465229
Br J Psychiatry. 2013 Jun;202:441-6
pubmed: 23580379
Am J Psychiatry. 2004 Sep;161(9):1626-34
pubmed: 15337653
Cost Eff Resour Alloc. 2013 Mar 25;11(1):6
pubmed: 23531194
Health Technol Assess. 2018 Nov;22(63):1-136
pubmed: 30468145
Med Decis Making. 1998 Apr-Jun;18(2 Suppl):S68-80
pubmed: 9566468
BMC Psychiatry. 2017 Aug 1;17(1):280
pubmed: 28764679
Health Technol Assess. 2012;16(10):1-164, iii-iv
pubmed: 22398106
Value Health. 2012 Mar-Apr;15(2):231-9
pubmed: 22433753
Expert Rev Pharmacoecon Outcomes Res. 2013 Apr;13(2):237-42
pubmed: 23570434
Epidemiol Psichiatr Soc. 2010 Apr-Jun;19(2):131-9
pubmed: 20815297
Pharmacoeconomics. 2019 Apr;37(4):597-608
pubmed: 30903567
J Med Internet Res. 2017 Jan 04;19(1):e5
pubmed: 28052841
Pharmacoeconomics. 2013 Dec;31(12):1105-19
pubmed: 24218135
Eur Psychiatry. 2006 Sep;21(6):349-54
pubmed: 16777385
Aust N Z J Psychiatry. 2009 Jun;43(6):539-47
pubmed: 19440886
Br J Psychiatry. 2014 Jan;204(1):69-76
pubmed: 24262818
Br J Psychiatry. 2013 Feb;202:121-8
pubmed: 23258767
Soc Psychiatry Psychiatr Epidemiol. 2016 Nov;51(11):1525-1537
pubmed: 27667656
Epidemiol Psichiatr Soc. 2010 Jul-Sep;19(3):223-32
pubmed: 21261218
J Occup Environ Med. 2008 Apr;50(4):401-10
pubmed: 18404013
PLoS Med. 2017 Sep 12;14(9):e1002385
pubmed: 28898283
J Affect Disord. 2013 Sep 25;150(3):790-7
pubmed: 23611536
Health Aff (Millwood). 2016 Jun 1;35(6):1130-5
pubmed: 27193027
J Ment Health Policy Econ. 2010 Mar;13(1):27-35
pubmed: 20571180
PLoS One. 2014 Aug 14;9(8):e104225
pubmed: 25121991
PLoS One. 2017 Aug 14;12(8):e0181021
pubmed: 28806775
Rev Esp Salud Publica. 2015 Jan-Feb;89(1):5-14
pubmed: 25946581
BMC Neurol. 2015 Dec 29;15:266
pubmed: 26715040
Lancet. 2018 Nov 10;392(10159):1789-1858
pubmed: 30496104
Gen Hosp Psychiatry. 2003 Sep-Oct;25(5):311-5
pubmed: 12972221
J Affect Disord. 2008 Nov;111(1):106-12
pubmed: 18342952
Can J Psychiatry. 2016 Sep;61(9):576-87
pubmed: 27486153
Eur J Health Econ. 2019 Nov;20(8):1207-1236
pubmed: 31342208
Trials. 2013 Sep 22;14:305
pubmed: 24053631
J Ment Health Policy Econ. 2009 Dec;12(4):195-204
pubmed: 20195007
Annu Rev Public Health. 2002;23:377-401
pubmed: 11910068
Br J Psychiatry. 2010 Oct;197(4):297-304
pubmed: 20884953
Pharmacoeconomics. 2015 Feb;33(2):123-35
pubmed: 25315368
Fam Pract. 2014 Oct;31(5):578-84
pubmed: 25121977
Eur J Health Econ. 2016 May;17(4):391-402
pubmed: 25876834
Clin Ther. 2012 Jun;34(6):1364-78
pubmed: 22578310
Pharmacoeconomics. 2012 Jun 1;30(6):513-30
pubmed: 22591130
Health Technol Assess. 2015 Sep;19(73):1-124
pubmed: 26379122
Int J Technol Assess Health Care. 2015;31(6):434-41
pubmed: 26961722
Am J Manag Care. 2015 Jun 01;21(6):e357-65
pubmed: 26247576
PLoS One. 2012;7(8):e42003
pubmed: 22876296
Int J Technol Assess Health Care. 2005 Spring;21(2):240-5
pubmed: 15921065
J Med Internet Res. 2010 Dec 19;12(5):e53
pubmed: 21169166
EMBO Rep. 2016 Sep;17(9):1245-9
pubmed: 27491723
Expert Rev Pharmacoecon Outcomes Res. 2017 Jun;17(3):293-302
pubmed: 27680105
Cost Eff Resour Alloc. 2012 Jul 16;10(1):8
pubmed: 22800192
J Occup Rehabil. 2014 Sep;24(3):555-62
pubmed: 24085535
Pediatrics. 2016 Dec;138(6):
pubmed: 27940701
Value Health. 2012 Sep-Oct;15(6):975-81
pubmed: 22999150
Heart. 2017 Nov;103(21):1746
pubmed: 29025922
J Ment Health Policy Econ. 2015 Dec;18(4):175-83
pubmed: 26729009
J Occup Environ Med. 2013 Mar;55(3):252-8
pubmed: 23439268
J Affect Disord. 2016 Aug;200:284-92
pubmed: 27155071
Br J Psychiatry. 2010 Nov;197(5):348-9
pubmed: 21037210
Pharmacoeconomics. 2019 Apr;37(4):451-456
pubmed: 30328563
PLoS One. 2014 Sep 02;9(9):e105430
pubmed: 25181469
Br J Psychiatry. 2010 Apr;196(4):310-8
pubmed: 20357309
CNS Drugs. 2015 Aug;29(8):695-712
pubmed: 26293743
PLoS One. 2018 Dec 19;13(12):e0208570
pubmed: 30566441
J Affect Disord. 2014 Apr;159:85-93
pubmed: 24679395
J Psychosom Res. 2015 Oct;79(4):316-23
pubmed: 26255095
Lancet. 2017 Jan 14;389(10065):176-185
pubmed: 27988143
J Ment Health Policy Econ. 2006 Jun;9(2):87-98
pubmed: 17007486
Eur Neuropsychopharmacol. 2016 Jun;26(6):1004-13
pubmed: 27085517
Adv Ther. 2009 Mar;26(3):346-68
pubmed: 19330495
BJPsych Open. 2016 Aug 9;2(4):262-269
pubmed: 27703785
BMC Psychiatry. 2017 Dec 29;17(1):415
pubmed: 29284448