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Considering the societal perspective in economic evaluations: a systematic review in the case of depression


  • Juliane Andrea Duevel

    (Bielefeld University, School of Public Health)

  • Lena Hasemann

    (Bielefeld University, School of Public Health)

  • Luz María Peña-Longobardo

    (University of Castilla-La Mancha)

  • Beatriz Rodríguez-Sánchez

    (University of Castilla-La Mancha
    University Camilo José Cela)

  • Isaac Aranda-Reneo

    (University of Castilla-La Mancha)

  • Juan Oliva-Moreno

    (University of Castilla-La Mancha)

  • Julio López-Bastida

    (University of Castilla-La Mancha)

  • Wolfgang Greiner

    (Bielefeld University, School of Public Health)


Background Depressive disorders are associated with a high burden of disease. However, due to the burden posed by the disease on not only the sufferers, but also on their relatives, there is an ongoing debate about which costs to include and, hence, which perspective should be applied. Therefore, the aim of this paper was to examine whether the change between healthcare payer and societal perspective leads to different conclusions of cost-utility analyses in the case of depression. Methods A systematic literature search was conducted to identify economic evaluations of interventions in depression, launched on Medline and the Cost-Effectiveness Registry of the Tufts University using a ten-year time horizon (2008–2018). In a two-stepped screening process, cost-utility studies were selected by means of specified inclusion and exclusion criteria. Subsequently, relevant findings was extracted and, if not fully stated, calculated by the authors of this work. Results Overall, 53 articles with 92 complete economic evaluations, reporting costs from healthcare payer/provider and societal perspective, were identified. More precisely, 22 estimations (24%) changed their results regarding the cost-effectiveness quadrant when the societal perspective was included. Furthermore, 5% of the ICURs resulted in cost-effectiveness regarding the chosen threshold (2% of them became dominant) when societal costs were included. However, another four estimations (4%) showed the opposite result: these interventions were no longer cost-effective after the inclusion of societal costs. Conclusions Summarising the disparities in results and applied methods, the results show that societal costs might alter the conclusions in cost-utility analyses. Hence, the relevance of the perspectives chosen should be taken into account when carrying out an economic evaluation. This systematic review demonstrates that the results of economic evaluations can be affected by different methods available for estimating non-healthcare costs.

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  • Juliane Andrea Duevel & Lena Hasemann & Luz María Peña-Longobardo & Beatriz Rodríguez-Sánchez & Isaac Aranda-Reneo & Juan Oliva-Moreno & Julio López-Bastida & Wolfgang Greiner, 2020. "Considering the societal perspective in economic evaluations: a systematic review in the case of depression," Health Economics Review, Springer, vol. 10(1), pages 1-19, December.
  • Handle: RePEc:spr:hecrev:v:10:y:2020:i:1:d:10.1186_s13561-020-00288-7
    DOI: 10.1186/s13561-020-00288-7

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    References listed on IDEAS

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    Blog mentions

    As found by, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 26th October 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-10-26 12:00:03


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    2. B. Rodríguez-Sánchez & S. Daugbjerg & L. M. Peña-Longobardo & J. Oliva-Moreno & I. Aranda-Reneo & A. Cicchetti & J. López-Bastida, 2023. "Does the inclusion of societal costs change the economic evaluations recommendations? A systematic review for multiple sclerosis disease," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(2), pages 247-277, March.

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