Clinical Edge

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CBT and Antidepressants Have Similar Costs for Major Depressive Disorder

Key clinical point: Although more expensive initially, the cost effectiveness of cognitive behavioral therapy (CBT) was similar to the long-term costs of second-generation antidepressants (SGA) in patients with major depressive disorder.

Major finding: Compared with SGA, there was an increase of 20 quality-adjusted life days in patients who received CBT at 5 years (QALY, 0.055; 95% confidence interval, 0.044-0.160), and the cost for CBT treatment was reduced by $2,000. While CBT appeared to be cost saving in the base-case analysis, researchers said there was some uncertainty in the cost effectiveness of CBT when they calculated the incremental net monetary benefit of CBT for the health care sector ($8,100-$21,700) and to society ($10,400-$25,300).

Study details: A decision-analytic model of cost-effectiveness for patients with major depressive disorder who received either CBT or SGA at 1 years and at 5 years.

Disclosures: This study was funded by grants from the U.S. Department of Veterans Affairs Health Services Research and Development and the National Institute of Mental Health. Dr. Ross reported receiving a grant from the National Institute of Mental Health. Two coauthors reported receiving grants from the Department of Veterans Affairs. Dr. Sinyor and Dr. Skolnik reported no conflicts of interest.


Ross EL et al. Ann Intern Med. 2019. doi: 10.7326/M18-1480.