Economic evaluation of resistant major depressive disorder treatment in Iranian population: a comparison between repetitive Transcranial Magnetic Stimulation with electroconvulsive

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GHIASVAND HESAM; MORADI JOO MOHAMMAD; ABOLHASSANI NAZANIN; RAVAGHI HAMID; Raygani Seyed Mansoor; MOHABBAT BAHAR SAHAR

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Journal Paper

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Journal: Medical Journal of The Islamic Republic of Iran Year:2016 | Volume:30 | Issue:1 Page(s): 0-0

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Title

Economic evaluation of resistant major depressive disorder treatment in Iranian population: a comparison between repetitive Transcranial Magnetic Stimulation with electroconvulsive

Author(s)

Keywords

Major Depressive disorders

Electroconvulsive Therapy

repetitive Transcranial Magnetic Stimulation

Decision tree

Abstract

Background: It is estimated that major depression disorders constitute 8. 2% of years lived with disability (YLDs) globally. The repetitive Transcranial Magnetic Stimulation (rTMS) and Electroconvulsive Therapy (ECT) are two relative common interventions to treat Major Depressive disorders, especially for treatment resistant depression. In this study the cost-effectiveness and cost-utility of rTMS were compared with ECT in Iranian population suffering from major depressive disorder using a Decision tree model. Methods: A Decision tree model conducted to compare the cost-effectiveness ratio of rTMS with ECT in a health system prospective and 7 months’ time horizon. The outcome variables were: response rate, remission rate and quality-adjusted life-years (QALYs) of the rTMS and ECT as primary and secondary outcomes extracted from systematic reviews and randomized control trials. The costs were also calculated through a field study in one clinic and one hospital; the direct costs have only been considered. Results: The total cost for rTMS and ECTstrategieswere11015000Rials (373US$) and 11742700 Rials (397. 7US$), respectively. Also the rTMS/ECT ratio of costs per improved patients was 1194410Rials (40. 5 US$); the ratio for costs per QALYs utility was 21017139 Rials (711. 72 US$). The incremental cost-effectiveness ratio of rTMS versus ECT was 1194410 Rials (40. 44 US$) after treatment and maintenance courses. Conclusion: Given the current prevalence of depressive disorders in Iranian population, the ECT is more cost-effective than TMS. The sensitivity analysis showed that if the prevalence of Major Depressive disorders declines to below 5% or the costs of rTMS decrease (rTMS provided by public sector), then the rTMS becomes more cost-effective compared with ECT. However, efficacy of rTMS depends on the frequency of pulsed magnetic field, the location of rTMS on the head, the number of therapeutic sessions and the length of each session.

Cites

EFFECTIVENESS OF REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION ON WORKING MEMORY OF PATIENTS WITH TREATMENT-RESISTANT MAJOR DEPRESSION DISORDER

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APA: Copy

GHIASVAND, HESAM, MORADI JOO, MOHAMMAD, ABOLHASSANI, NAZANIN, RAVAGHI, HAMID, Raygani, Seyed Mansoor, & MOHABBAT BAHAR, SAHAR. (2016). Economic evaluation of resistant major depressive disorder treatment in Iranian population: a comparison between repetitive Transcranial Magnetic Stimulation with electroconvulsive. MEDICAL JOURNAL OF THE ISLAMIC REPUBLIC OF IRAN (MJIRI), 30(1), 0-0. SID. https://sid.ir/paper/294521/en

Vancouver: Copy

GHIASVAND HESAM, MORADI JOO MOHAMMAD, ABOLHASSANI NAZANIN, RAVAGHI HAMID, Raygani Seyed Mansoor, MOHABBAT BAHAR SAHAR. Economic evaluation of resistant major depressive disorder treatment in Iranian population: a comparison between repetitive Transcranial Magnetic Stimulation with electroconvulsive. MEDICAL JOURNAL OF THE ISLAMIC REPUBLIC OF IRAN (MJIRI)[Internet]. 2016;30(1):0-0. Available from: https://sid.ir/paper/294521/en

IEEE: Copy

HESAM GHIASVAND, MOHAMMAD MORADI JOO, NAZANIN ABOLHASSANI, HAMID RAVAGHI, Seyed Mansoor Raygani, and SAHAR MOHABBAT BAHAR, “Economic evaluation of resistant major depressive disorder treatment in Iranian population: a comparison between repetitive Transcranial Magnetic Stimulation with electroconvulsive,” MEDICAL JOURNAL OF THE ISLAMIC REPUBLIC OF IRAN (MJIRI), vol. 30, no. 1, pp. 0–0, 2016, [Online]. Available: https://sid.ir/paper/294521/en

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