Table 19:
Cost–Utility Analyses Comparing iTBS With ECT and Pharmacotherapy Alone in Adults With TRD—Reference Case Analysis
| Strategy | Average Total Cost ($), Mean (95% CI) | Incremental Cost ($),a Mean (95% CI) | Average Total Effect in QALYs, Mean (95% CI) | Incremental Effect in QALYs,b Mean (95% CI) | ICER, $/QALY |
|---|---|---|---|---|---|
| iTBS vs. ECT | |||||
| iTBS (stepped care pathway) | 13,217 (8,975–18,408) | −12,579 (−16,875 to −7,504)c | 1.7444 (1.5094–1.8112) | 0.1135 (0.0745–0.1468) | Dominantd |
| ECT alone | 25,796 (23,508–26,666) | — | 1.6309 (1.4078–1.6883) | — | — |
| iTBS vs. Pharmacotherapy Alone | |||||
| iTBS (stepped care pathway) | 13,217 (8,975–18,408) | 11,703 (7,519–16,878) | 1.7444 (1.5094–1.8112) | 0.5505 (0.4792–0.5987) | 21,259 |
| Pharmacotherapy alone | 1,515 (1,272–1,570) | — | 1.1939 (1.0267–1.2403) | — | — |
Abbreviations: CI, confidence interval; ECT, electroconvulsive therapy; ICER, incremental cost-effectiveness ratio; iTBS, intermittent theta burst stimulation; QALY, quality-adjusted life-year; TRD, treatment-resistant depression.
a
Incremental cost = Average cost (strategy B) − Average cost (strategy A).
b
Incremental effect = Average effect (strategy B) − Average effect (strategy A).
c
Negative costs indicate cost savings.
d
Dominant is less costly and more effective.