Cost-Utility of a Digital Wellness Intervention for Managing Depression and Anxiety Symptoms: A Payer Perspective
Author(s)
Mohandas A1, Tak CR2, Kavelaars R3, Mathur I3
1Happify Health, TUSTIN , CA, USA, 2Blue Mountain Health Outcomes, LLC, Arden, NC, USA, 3Happify Health, New York, NY, USA
Objectives: To examine cost-effectiveness for payers, with respect to quality-adjusted life years (QALYs), of a digital wellness intervention (DWI) for managing depression and anxiety relative to psychoeducation. Methods: A Markov model of 10,000 hypothetical individuals was created to estimate costs (2019 USD) and QALYs for a DWI (Happify Health) vs. psychoeducation. Four depression-related health states (none, mild, moderate, severe) were used, with a subdistribution of anxiety levels (none, mild/moderate, severe) within each state. Efficacy data from a RCT that compared a DWI to psychoeducation in people with moderate to severe depression (PHQ>9) was used. Direct treatment costs were estimated from the Kantar 2019 National Health and Wellness Survey (NHWS) for each depression and concurrent anxiety level. Health utility estimates based on NHWS Short Form (SF)-6D responses for corresponding health states were converted into QALYs. Individuals were cycled through each intervention over six months, with cycle lengths of two months. Incremental cost-effectiveness ratios (ICER) and net monetary benefit (NMB) were determined at a willingness-to-pay threshold of $150,000. One-way sensitivity analysis (SA) examined individual parameter uncertainty. Two-way SA explored the impact of varying intervention costs. Deterministic SA was used to examine the impact of dropout rates. Data were analyzed in TreeAge Pro 2021 (TreeAge Software, Williamstown, MA). Results: The DWI and psychoeducation incurred mean costs of $3604 and $3602 and mean QALYs of 0.852 and 0.849, respectively. The ICER was $7543 per QALY gained. The most sensitive parameters were the cost of the DWI and the probabilities of moving from moderate to severe and from severe to mild depression. The DWI was cost-effective when costs were $100-$230. NMB was favorable for the DWI in 46% of simulations. Conclusion: With respect to QALYs, the DWI was cost-effective vs. psychoeducation and its introduction at a population level could benefit payers.
Conference/Value in Health Info
2022-05, ISPOR 2022, Washington, DC, USA
Value in Health, Volume 25, Issue 6, S1 (June 2022)
Code
EE104
Topic
Economic Evaluation, Medical Technologies, Patient-Centered Research
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis, Digital Health, Health State Utilities
Disease
No Additional Disease & Conditions/Specialized Treatment Areas
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