Economic evaluations of commonly used structured psychotherapies for major depressive disorder and generalized anxiety disorder: A systematic review.

Face-to-face cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT) are time-limited, structured psychotherapies recommended for the management of adult major depressive disorder (MDD) and generalized anxiety disorder (GAD). We conducted a systematic review to evaluate the reporting and methodological quality, and cost-effectiveness of economic evaluations that examined these two thoroughly researched psychotherapies. Economic studies were retrieved through systematic searches of bibliographic databases (e.g., Ovid MEDLINE, Embase, PsycINFO: January 2000 to February 2018) and grey literature. The reporting and methodological quality of the studies was independently evaluated by two reviewers using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist and Quality of Health Economic Studies (QHES) tool. The cost-effectiveness results were qualitatively synthesized. Fifteen out of 161 identified economic evaluations were included: 14 examined CBT and one IPT. None was conducted in Canada. Based on the CHEERS criteria, overall reporting quality of the included studies was good. Eighty-seven percent of the included studies were of high quality based on the QHES criteria. Most of these studies examined the cost-effectiveness of individually delivered CBT (alone or with pharmacotherapy) over a short time horizon. CBT represented good value for money at different country-specific willingness-to-pay thresholds. The cost-effectiveness of IPT was uncertain. In conclusion, the quality of economic analyses examining structured psychotherapies is good. Face-to-face CBT represents good value for money in the management of adult MDD and GAD though no study was done in Canada. The long-term cost-effectiveness of the group versus individual format remains unclear and warrants further research. (PsycINFO Database Record (c) 2018 APA, all rights reserved)