The Cost-Effectiveness of Depression Treatment for Co-Occurring Disorders

A Clinical Trial

Published In: Journal of Substance Abuse Treatment, v. 46, no. 2, Feb. 2014, p. 128-133

Posted on RAND.org on January 01, 2013

by Katherine E. Watkins, Alison Evans Cuellar, Kimberly A. Hepner, Sarah B. Hunter, Susan M. Paddock, Brett Ewing, Erin Dela Cruz

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Research Question

  1. Is it cost-effective to provide on-site group cognitive behavioral therapy for depression to clients receiving residential treatment for substance abuse?

The authors aimed to determine the economic value of providing on-site group cognitive behavioral therapy (CBT) for depression to clients receiving residential substance use disorder (SUD) treatment. Using a quasi-experimental design and an intention-to-treat analysis, the incremental cost-effectiveness and cost-utility ratio of the intervention were estimated relative to usual care residential treatment. The average cost of a treatment episode was $908, compared to $180 for usual care. The incremental cost effectiveness ratio was $131 for each point improvement of the BDI-II and $49 for each additional depression-free day. The incremental cost–utility ratio ranged from $9,249 to $17,834 for each additional quality adjusted life year. Although the intervention costs substantially more than usual care, the cost effectiveness and cost–utility ratios compare favorably to other depression interventions. Health care reform should promote dissemination of group CBT to individuals with depression in residential SUD treatment.

Key Findings

  • Providing on-site group cognitive behavior therapy (CBT) on site costs more than usual care for those receiving residential treatment for substance abuse.
  • However, the cost-effectiveness and cost-utility ratios of on-site CBT compare favorably to other depression interventions.

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