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dc.contributor.authorNguyen, Kim-Huong
dc.contributor.authorGordon, Louisa
dc.date.accessioned2017-06-02T00:32:08Z
dc.date.available2017-06-02T00:32:08Z
dc.date.issued2015
dc.identifier.issn1098-3015en_US
dc.identifier.doi10.1016/j.jval.2015.04.004en_US
dc.identifier.urihttp://hdl.handle.net/10072/101410
dc.description.abstractBackground: Repetitive transcranial magnetic stimulation (rTMS) therapy is a clinically safe, noninvasive, nonsystemic treatment for major depressive disorder. Objective: We evaluated the cost-effectiveness of rTMS versus pharmacotherapy for the treatment of patients with major depressive disorder who have failed at least two adequate courses of antidepressant medications. Methods: A 3-year Markov microsimulation model with 2-monthly cycles was used to compare the costs and quality-adjusted life-years (QALYs) of rTMS and a mix of antidepressant medications (including selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, tricyclics, noradrenergic and specific serotonergic antidepressants, and monoamine oxidase inhibitors). The model synthesized data sourced from published literature, national cost reports, and expert opinions. Incremental cost-utility ratios were calculated, and uncertainty of the results was assessed using univariate and multivariate probabilistic sensitivity analyses. Results: Compared with pharmacotherapy, rTMS is a dominant/cost-effective alternative for patients with treatment-resistant depressive disorder. The model predicted that QALYs gained with rTMS were higher than those gained with antidepressant medications (1.25 vs. 1.18 QALYs) while costs were slightly less (AU $31,003 vs. AU $31,190). In the Australian context, at the willingness-to-pay threshold of AU $50,000 per QALY gain, the probability that rTMS was cost-effective was 73%. Sensitivity analyses confirmed the superiority of rTMS in terms of value for money compared with antidepressant medications. Conclusions: Although both pharmacotherapy and rTMS are clinically effective treatments for major depressive disorder, rTMS is shown to outperform antidepressants in terms of cost-effectiveness for patients who have failed at least two adequate courses of antidepressant medications.en_US
dc.description.peerreviewedYesen_US
dc.languageEnglishen_US
dc.publisherElsevieren_US
dc.relation.ispartofpagefrom597en_US
dc.relation.ispartofpageto604en_US
dc.relation.ispartofissue5en_US
dc.relation.ispartofjournalValue in Healthen_US
dc.relation.ispartofvolume18en_US
dc.subject.fieldofresearchPublic Health and Health Services not elsewhere classifieden_US
dc.subject.fieldofresearchcode111799en_US
dc.titleCost-Effectiveness of Repetitive Transcranial Magnetic Stimulation versus Antidepressant Therapy for Treatment-Resistant Depressionen_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Peer Reviewed (HERDC)en_US
dc.type.codeC - Journal Articlesen_US
dcterms.licensehttp://creativecommons.org/licenses/by-nc-nd/4.0/en_US
dc.description.versionPost-printen_US
gro.facultyGriffith Health, School of Medicineen_US
gro.rights.copyright© 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc.. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (http://creativecommons.org/licenses/by-nc-nd/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.en_US
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