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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.

Citation:

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