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The population cost-effectiveness of interventions designed to prevent childhood depression

journal contribution
posted on 01.03.2012, 00:00 authored by Cathy Mihalopoulos, T Vos, J Pirkis, Rob CarterRob Carter
BACKGROUND AND OBJECTIVES: Depression in childhood and adolescence is common and often persists into adulthood. This study assessed the population-level cost-effectiveness of a preventive intervention that screens children and adolescents for symptoms of depression in schools and the subsequent provision of a psychological intervention to those showing elevated signs of depression. The target population for screening comprised 11- to 17-year-old children and adolescents in the 2003 Australian population.

METHODS: Economic modeling techniques were used to assess the incremental cost-effectiveness of the intervention compared with no intervention. The perspective was that of the health sector, and outcomes were measured by using disability-adjusted life-years (DALYs). Multivariate probabilistic and univariate sensitivity testing was applied to quantify variations in the model parameters.

RESULTS:
The modeled psychological intervention had an incremental cost-effectiveness ratio of $5400 per DALY averted, with just 2% of iterations falling above a $50 000 per DALY value-for-money threshold. Results were robust to model assumptions.

CONCLUSIONS:
After school screening, screening and the psychological intervention represent good value-for-money. Such an intervention needs to be seriously considered in any national package of preventive health services. Acceptability issues, particularly to intervention providers, including schools and mental health professionals, need to be considered before wide-scale adoption.

History

Journal

Pediatrics

Volume

129

Issue

3

Pagination

723 - 730

Publisher

American Academy of Pediatrics

Location

Elk Grove Village, Ill.

ISSN

0031-4005

eISSN

1098-4275

Language

eng

Publication classification

C1 Refereed article in a scholarly journal

Copyright notice

2012, American Academy of Pediatrics