Table 3.

Cost Effectiveness Data of Interventions

Reference or Study Name	Population	Study Design, Intervention, and Primary Aim	Findings
SADHART (Sertraline Antidepressant Heart Attack Randomized Trial) 71	369 post‐ACS patients with MDD	24‐wk RCT comparing sertraline (50–200 mg) with placebo, aimed at evaluating safety and efficacy of sertraline for MDD in patients with ACS	The mean cost of psychiatric and medical care per patient for the intervention group was 2733 US dollars and 3326 US dollars for placebo, albeit not statistically significant (P=0.32). There was no increase in overall medical care costs for sertraline compared with placebo after including the costs of the sertraline over 24 wk
Bypassing the Blues 72	302 patients post–coronary artery bypass surgery with elevated depressive symptoms	8‐mo RCT comparing phone‐, nurse‐delivered collaborative care depression management to enhanced usual care (collaborative care for cardiac diagnosis) to evaluate effectiveness in treating depression	Patients in the intervention group had $2068 lower median costs, although nonsignificant, compared with usual care (P=0.30). There were no significant changes in sensitivity analyses after removing outliers and doubling estimated cost of intervention to account for overlooked costs. The incremental cost‐effectiveness ratio was −$9889 per additional QALY
TEAMCare 73	214 patients with type 2 diabetes mellitus and/or CAD and depression	12‐mo RCT of collaborative care management for depression and medical conditions to examine effectiveness in controlling risk factors associated with multiple diseases	The intervention group had lower mean outpatient health costs of $594 per patient (95% CI, −$3241 to $2053) relative to UC patients
MOASAIC (Management of Sadness and Anxiety in Cardiology) 74	183 patients with ACS, HF, or arrhythmia and depression, panic disorder, or generalized anxiety disorder	24‐wk RCT of an inpatient initiated, phone‐delivered, collaborative care depression and anxiety management program compared with enhanced usual care	The cost of mental health care was greater in intervention than control group ($209.86 vs $34.59; z=−11.71; P<0.001). The incremental cost‐effectiveness ratio was $3337.06 per QALY saved, $13.36 per depression‐free day, and $13.74 per anxiety‐free day. Compared with enhanced usual care, the intervention was also associated with fewer emergency department visits but no differences in overall costs
COADIACS (Comparison of Depression Interventions After Acute Coronary Syndrome) 52	150 post‐ACS patients with elevated depression symptoms	6‐mo RCT of depression stepped‐care management intervention (phone or internet) vs usual care evaluating effectiveness in reducing depressive symptoms	The intervention group had significantly higher mental health cost (adjusted change, $687; 95% CI, $466–$909; P<0.001), while average hospital costs were lower (adjusted change, −$1010; 95% CI, −$3294 to $1274; P=0.39). Total healthcare costs in the study intervention group resulted in nonsignificantly lower costs than the control group (adjusted change, −$325; 95% CI, −$2639 to $1989; P=0.78)

ACS indicates acute coronary syndrome; CAD, coronary artery disease; HF, heart failure; MDD, major depressive disorder; QALY, quality‐adjusted life‐year; RCT, randomized clinical trial; and UC, usual care.