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Cost-Effectiveness Analysis of Acupuncture, Counselling and Usual Care in Treating Patients with Depression: The Results of the ACUDep Trial

Author

Listed:
  • Eldon Spackman
  • Stewart Richmond
  • Mark Sculpher
  • Martin Bland
  • Stephen Brealey
  • Rhian Gabe
  • Ann Hopton
  • Ada Keding
  • Harriet Lansdown
  • Sara Perren
  • David Torgerson
  • Ian Watt
  • Hugh MacPherson

Abstract

Background: New evidence on the clinical effectiveness of acupuncture plus usual care (acupuncture) and counselling plus usual care (counselling) for patients with depression suggests the need to investigate the health-related quality of life and costs of these treatments to understand whether they should be considered a good use of limited health resources. Methods and Findings: The cost-effectiveness analyses are based on the Acupuncture, Counselling or Usual care for Depression (ACUDep) trial results. Statistical analyses demonstrate a difference in mean quality adjusted life years (QALYs) and suggest differences in mean costs which are mainly due to the price of the interventions. Probabilistic sensitivity analysis is used to express decision uncertainty. Acupuncture and counselling are found to have higher mean QALYs and costs than usual care. In the base case analysis acupuncture has an incremental cost-effectiveness ratio (ICER) of £4,560 per additional QALY and is cost-effective with a probability of 0.62 at a cost-effectiveness threshold of £20,000 per QALY. Counselling compared with acupuncture is more effective and more costly with an ICER of £71,757 and a probability of being cost-effective of 0.36. A scenario analysis of counselling versus usual care, excluding acupuncture as a comparator, results in an ICER of £7,935 and a probability of 0.91. Conclusions: Acupuncture is cost-effective compared with counselling or usual care alone, although the ranking of counselling and acupuncture depends on the relative cost of delivering these interventions. For patients in whom acupuncture is unavailable or perhaps inappropriate, counselling has an ICER less than most cost-effectiveness thresholds. However, further research is needed to determine the most cost-effective treatment pathways for depressed patients when the full range of available interventions is considered.

Suggested Citation

  • Eldon Spackman & Stewart Richmond & Mark Sculpher & Martin Bland & Stephen Brealey & Rhian Gabe & Ann Hopton & Ada Keding & Harriet Lansdown & Sara Perren & David Torgerson & Ian Watt & Hugh MacPherso, 2014. "Cost-Effectiveness Analysis of Acupuncture, Counselling and Usual Care in Treating Patients with Depression: The Results of the ACUDep Trial," PLOS ONE, Public Library of Science, vol. 9(11), pages 1-12, November.
  • Handle: RePEc:plo:pone00:0113726
    DOI: 10.1371/journal.pone.0113726
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    References listed on IDEAS

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    1. Paul Dolan & Claire Gudex, 1995. "Time preference, duration and health state valuations," Health Economics, John Wiley & Sons, Ltd., vol. 4(4), pages 289-299, July.
    2. Hugh MacPherson & Stewart Richmond & Martin Bland & Stephen Brealey & Rhian Gabe & Ann Hopton & Ada Keding & Harriet Lansdown & Sara Perren & Mark Sculpher & Eldon Spackman & David Torgerson & Ian Wat, 2013. "Acupuncture and Counselling for Depression in Primary Care: A Randomised Controlled Trial," PLOS Medicine, Public Library of Science, vol. 10(9), pages 1-13, September.
    3. Claxton, Karl, 1999. "The irrelevance of inference: a decision-making approach to the stochastic evaluation of health care technologies," Journal of Health Economics, Elsevier, vol. 18(3), pages 341-364, June.
    4. Jürgen Barth & Thomas Munder & Heike Gerger & Eveline Nüesch & Sven Trelle & Hansjörg Znoj & Peter Jüni & Pim Cuijpers, 2013. "Comparative Efficacy of Seven Psychotherapeutic Interventions for Patients with Depression: A Network Meta-Analysis," PLOS Medicine, Public Library of Science, vol. 10(5), pages 1-17, May.
    5. Colin D Mathers & Dejan Loncar, 2006. "Projections of Global Mortality and Burden of Disease from 2002 to 2030," PLOS Medicine, Public Library of Science, vol. 3(11), pages 1-20, November.
    6. Andrea Manca & Neil Hawkins & Mark J. Sculpher, 2005. "Estimating mean QALYs in trial‐based cost‐effectiveness analysis: the importance of controlling for baseline utility," Health Economics, John Wiley & Sons, Ltd., vol. 14(5), pages 487-496, May.
    7. Karl Claxton & Steve Martin & Marta Soares & Nigel Rice & Eldon Spackman & Sebastian Hinde & Nancy Devlin & Peter C Smith & Mark Sculpher, 2013. "Methods for the estimation of the NICE cost effectiveness threshold," Working Papers 081cherp, Centre for Health Economics, University of York.
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