Umeå University's logo

umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Cost-utility analysis of esketamine and electroconvulsive therapy in adults with treatment-resistant depression
Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.ORCID iD: 0000-0003-2478-9598
Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.ORCID iD: 0000-0002-0457-2175
2021 (English)In: BMC Psychiatry, E-ISSN 1471-244X, Vol. 21, no 1, article id 610Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Electroconvulsive therapy (ECT) has long been used for treating individuals with treatment-resistant depression (TRD). Esketamine has recently emerged as a new treatment for TRD due to its rapid antidepressant effects. To further inform the decision regarding choice of treatment, this paper aims to evaluate whether ECT or esketamine is the more cost-effective option.

METHODS: The cost-effectiveness was derived as cost per quality-adjusted life-year (QALY) using a Markov model from a societal and life-time perspective. The incremental cost-effectiveness ratio (ICER) was calculated. Health states included different depression and remission states and death. Data to populate the model was derived from randomised controlled trials and other research. Various sensitivity analyses were carried out to test the robustness of the model.

RESULTS: The base case scenario shows that ECT is cost-effective compared to esketamine and yields more QALYs at a lower cost. The sensitivity analysis shows that ECT is cost-effective in all scenarios and ECT dominates esketamine in 12 scenarios.

CONCLUSIONS: This study found that, from a cost-effectiveness point of view, ECT should be the first-hand option for individuals with TRD, when other first line treatments have failed. Considering the lack of economic evaluation of ECT and esketamine, this study is of great value to decision makers.

Place, publisher, year, edition, pages
BioMed Central, 2021. Vol. 21, no 1, article id 610
Keywords [en]
Cost-effectiveness, Electroconvulsive therapy, Esketamine, ICER, Markov model, QALY, Treatment-resistant depression
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Psychiatry
Identifiers
URN: urn:nbn:se:umu:diva-190447DOI: 10.1186/s12888-021-03601-8ISI: 000728321500003PubMedID: 34876085Scopus ID: 2-s2.0-85120933852OAI: oai:DiVA.org:umu-190447DiVA, id: diva2:1620404
Available from: 2021-12-15 Created: 2021-12-15 Last updated: 2024-01-17Bibliographically approved

Open Access in DiVA

fulltext(1136 kB)125 downloads
File information
File name FULLTEXT01.pdfFile size 1136 kBChecksum SHA-512
cbe2a80de8f1eb4777662dacc0afccbbcb29f5637a3e4ae9d82aa1164c371b9307a22ba3da75464dd5ce4d95285cb1fd5ba3ece66398ca06c6decc57998a7474
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMedScopus

Authority records

Asellus, PeterMyléus, AnnaNorström, Fredrik

Search in DiVA

By author/editor
Asellus, PeterMyléus, AnnaNorström, Fredrik
By organisation
Department of Epidemiology and Global HealthPsychiatryFamily Medicine
In the same journal
BMC Psychiatry
Health Care Service and Management, Health Policy and Services and Health EconomyPsychiatry

Search outside of DiVA

GoogleGoogle Scholar
Total: 125 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 279 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf