Cost-Effectiveness of a Digital Wellness Intervention for Managing Depression and Anxiety: 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 the cost-effectiveness for payers, with respect to reduction of depression severity, 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) for a DWI (Happify Health) and psychoeducation. Four depression-related health states (none, mild, moderate, severe) were used, with a sub-distribution of anxiety levels (none, mild/moderate, severe) within each state. Effectiveness was defined as the proportion of people with severe depression who moved to milder depressive states. 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 (all-cause medical utilization) were estimated from Kantar’s 2019 National Health and Wellness Survey (NHWS) for each depression and concurrent anxiety level. Individuals were cycled through each intervention over a time horizon of 6 months with cycle lengths of two months. Incremental cost-effectiveness ratios (ICER) and net monetary benefit (NMB) were estimated at a willingness-to-pay threshold (WTP) of $150,000. One-way sensitivity analysis (SA) examined individual parameter uncertainty. Two-way SA and deterministic SA was used to examine parameter uncertainty.. Probabilistic SA estimated joint uncertainty. Data were analyzed in TreeAge Pro 2021 (TreeAge Software, Williamstown, MA). Results: With respect to reducing severe depression, the DWI had incremental-effectiveness of 0.00310 and cost $3.5 relative to psychoeducation, resulting in an ICER of $1,146. The most sensitive parameter was the probability of moving from moderate to severe depression. The DWI was cost-effective more than 50% of the time above a WTP of $20K. Conclusion: With respect to reduction of severe depression, 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
EE208
Topic
Economic Evaluation, Medical Technologies
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis, Digital Health
Disease
No Additional Disease & Conditions/Specialized Treatment Areas