BackgroundThere is an urgent need for the development of cost-effective preventive
strategies to reduce the onset of mental disorders.AimsTo establish the cost-effectiveness of a stepped care preventive
intervention for depression and anxiety disorders in older people at high
risk of these conditions, compared with routine primary care.MethodAn economic evaluation was conducted alongside a pragmatic randomised
controlled trial (ISRCTN26474556). Consenting individuals presenting with
subthreshold levels of depressive or anxiety symptoms were randomly
assigned to a preventive stepped care programme (n = 86)
or to routine primary care (n = 84).ResultsThe intervention was successful in halving the incidence rate of
depression and anxiety at €563 (£412) per recipient and €4367 (£3196) per
disorder-free year gained, compared with routine primary care. The latter
would represent good value for money if the willingness to pay for a
disorder-free year is at least €5000.ConclusionsThe prevention programme generated depression- and anxiety-free survival
years in the older population at affordable cost.
Cost-effectiveness of a stepped care intervention to prevent
depression and anxiety in late life: randomised trial
