OBJECTIVE: The primary objective of this study was to assess the appropriateness of the existing Dutch guidelines (“NHG-standard”) from a health economic perspective. Those guidelines recommend continuation treatment for period of 6 months. We also assessed additional maintenance treatment for 1 year after the continuation period. METHODS: The assessment was based on a Markov model based on decision analytic techniques. For this analysis we defined 3 mutually exclusive states: no depression (ND), depression with treatment in ambulatory setting (DA), depression / treatment failure requiring hospitalization (DH). The outcomes for the model have been defined as: QALYs and direct medical, while the study was performed from the health insurance perspective in The Netherlands in 1999. The probabilities of clinical events and therapeutic choices as well as the utilities were based on published literature. The medical resource use related to each state was abstracted from published literature and expert opinion. The associated 1999 unit costs of the used medical resources were derived from official Dutch tariff lists. RESULTS: The results of the baseline analysis showed that a treatment according to the guidelines will result in an incremental cost-effectiveness ratio of 81,700 NLG per QALY. Treatment according to the guidelines increased the total costs from NLG 49 to NLG 683, while the number of QALYs increased from 0.45 to 0.47. Sensitivity analyses confirmed the robustness of these findings. Extension of treatment to maintenance treatment (6 months and 12 months) reduced the incremental cost-effectiveness ratio to only 12,330 NLG per QALY. CONCLUSION: In conclusion, based on the assumptions used in the model, the Dutch clinical guidelines for depression are appropriate from a health economic perspective, when they are extended to beyond continuation period until maintenance treatment.