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The British Journal of Psychiatry

Year: 2010  |  Volume: 197  |  Issue: 4  |  Page No.: 291 - 296

Cost-effectiveness of improved primary care treatment of depression in women in Chile

D Siskind, R Araya and J. Kim



Low- and middle-income countries lack information on contextualised mental health interventions to aid resource allocation decisions regarding healthcare.


To undertake a cost-effectiveness analysis of treatments for depression contextualised to Chile.


Using data from studies in Chile, we developed a computer-based Markov cohort model of depression among Chilean women to evaluate the cost-effectiveness of usual care or improved stepped care.


The incremental cost-effectiveness ratio (ICER) of usual care was I$113 per quality-adjusted life-year (QALY) gained, versus no treatment, whereas stepped care had an ICER of I$468 per QALY versus usual care. This compared favourably with Chile’s per-capita GDP. Results were most sensitive to variation in recurrent episode coverage, marginally sensitive to cost of treatment, and insensitive to changes in health-state utility of depression and rate of recurrence.


Our results suggest that treatments for depression in low- and middle-income countries may be more cost-effective than previously estimated.

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