Cost Effectiveness of Pharmacological and Non-pharmacological Treatments for Depression in Low- and Middle-Income Countries: A Systematic Literature Review

Yared Belete Belay (), Lidia Engel, Yong Yi Lee, Ngoc Le and Cathrine Mihalopoulos
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Yared Belete Belay: Monash University
Lidia Engel: Monash University
Yong Yi Lee: Monash University
Ngoc Le: Deakin University
Cathrine Mihalopoulos: Monash University

PharmacoEconomics, 2023, vol. 41, issue 6, No 4, 673 pages

Abstract: Abstract Background Various treatment approaches are available for depression. Given the scarcity of healthcare resources, it is important to optimise treatment availability in an efficient manner. Economic evaluations can inform the optimal allocation of healthcare resources. However, there is currently no review synthesising what is known about the cost effectiveness of treatments for depression in low- and middle-income countries (LMICs). Methods This review identified articles from six database searches: APA PsycINFO, CINAHL Complete, Cochrane Library, EconLit, Embase and MEDLINE Complete. Trial- and model-based economic evaluations published between 1 January 2000 and 3 December 2022 were included. The quality of health economic studies (QHES) instrument was used to assess the quality of the included papers. Results This review comprised 22 articles, with most studies (N = 17) focusing exclusively on the adult population. Even though evidence regarding the cost effectiveness of antidepressants for treating various forms of depression was inconsistent; an atypical antipsychotic (aripiprazole) was frequently reported to be cost effective for treatment-resistant depression. Task shifting (aka task sharing) to lay health workers or non-specialist health care providers appeared to be a cost-effective approach for treating depression in LMICs. Conclusions Overall, this review found mixed evidence on the cost effectiveness of depression treatment choices among LMICs, with some indication that task sharing with lay health workers may be cost effective. Future research will be needed to fill the gaps around the cost effectiveness of depression treatments in younger people and beyond healthcare facilities.

Date: 2023
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DOI: 10.1007/s40273-023-01257-8

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