@article{ref1,
title="Relative Cost-Effectiveness of Treatments for Adolescent Depression: 36-Week Results From the TADS Randomized Trial",
journal="Journal of the American Academy of Child and Adolescent Psychiatry",
year="2009",
author="Domino, Marisa Elena and Foster, E. Michael and Vitiello, Benedetto and Kratochvil, Christopher J. and Burns, B. J. and Silva, Susan G. and Reinecke, Mark A. and March, John S.",
volume="48",
number="7",
pages="711-720",
abstract="OBJECTIVE:: The cost-effectiveness of three active interventions for major depression in adolescents was compared after 36 weeks of treatment in the Treatment of Adolescents with Depression Study. METHOD:: Outpatients aged 12 to 18 years with a primary diagnosis of major depression participated in a randomized controlled trial conducted at 13 U.S. academic and community clinics from 2000 to 2004. Three hundred twenty-seven participants randomized to 1 of 3 active treatment arms, fluoxetine alone (n = 109), cognitive-behavioral therapy (n = 111) alone, or their combination (n = 107), were evaluated for a 3-month acute treatment and a 6-month continuation/maintenance treatment period. Costs of services received for the 36 weeks were estimated and examined in relation to the number of depression-free days and quality-adjusted life-years. Cost-effectiveness acceptability curves were also generated. Sensitivity analyses were conducted to assess treatment differences on the quality-adjusted life-years and cost-effectiveness measures. RESULTS:: Cognitive-behavioral therapy was the most costly treatment component (mean $1,787 [in monotherapy] and $1,833 [in combination therapy], median $1,923 [for both]). Reflecting higher direct and indirect costs associated with psychiatric hospital use, the costs of services received outside Treatment of Adolescents with Depression Study in fluoxetine-treated patients (mean $5,382, median $2,341) were significantly higher than those in participants treated with cognitive-behavioral therapy (mean $3,102, median $1,373) or combination (mean $2,705, median $927). Accordingly, cost-effectiveness acceptability curves indicate that combination treatment is highly likely (>90%) to be more cost-effective than fluoxetine alone at 36 weeks. Cognitive-behavioral therapy is not likely to be more cost-effective than fluoxetine. CONCLUSIONS:: These findings support the use of combination treatment in adolescents with depression over monotherapy.<p /> <p>Language: en</p>",
language="en",
issn="0890-8567",
doi="10.1097/CHI.0b013e3181a2b319",
url="http://dx.doi.org/10.1097/CHI.0b013e3181a2b319"
}