Background. The effectiveness of collaborative care for patients with major depressive disorder in primary care has been established. Assessing its cost-effectiveness is important for deciding on implementation. This review therefore evaluates the cost-effectiveness of collaborative care for major depressive disorder in primary care. Methods. A systematic search on economic evaluations of collaborative care was conducted in Pubmed and PsychInfo. Quality of the studies was measured with the Cochrane checklist and the CHEC-list for economic evaluations. Cost-effectiveness and costs per depression-free days were reported. Results. 8 studies were found, involving 4868 patients. The quality of the cost effectiveness studies, according to the CHEC-list, could be improved. Generally, the studies did not include all relevant costs and did not perform sensitivity analysis. Only 4 out of 8 studies reported cost per QALY, 6 out of 8 reported costs per depression-free days. The highest costs per QALY reported were $49,500, the highest costs per depression-free day were $24. Conclusions. Although studies did not fulfil all criteria of the CHEC-list, collaborative care is a promising intervention and it may be cost-effective. However, to conclude on the cost-effectiveness, depression research should follow economic guidelines to improve the quality of the economic evaluations.

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Journal BMC Health Services Research
Note Article number 19
van Steenbergen-Weijenburg, K.M, van der Feltz-Cornelis, C.M, Horn, E.K, van Marwijk, H.W, Beekman, A.T.F, Rutten, F.F.H, & van Hakkaart-van Roijen, L. (2010). Cost-effectiveness of collaborative care for the treatment of major depressive disorder in primary care. A systematic review. BMC Health Services Research (Vol. 10). doi:10.1186/1472-6963-10-19