Table 17:
Costs and Resource Use Inputs in Economic Model
| Variable | Total Costs, $ Mean (SE)a | Distribution (Parameters)b | Reference |
|---|---|---|---|
| Multi-gene Pharmacogenomic Testing (One-Time Cost) | |||
| Testing including sample transportation costs | 2,500 (625) | Gamma (α: 16; λ : 0.0064) | Tanner et al, 202078 |
| Physician costs (for 2 visits) | 135.5 (67.75/visit) | NA (fixed) | OHIP code K005113 |
| Direct Medical Costs c,d | |||
| Remission, total annual costs (2018 CAD) • Medication (prescription drug) costs, annual (2018 CAD)c ○ Medication costs, monthly (2020 CAD): First 6 months ÷ rest of follow-upd • Health care service resource use and hospitalization costs, annual (2018 CAD)c ○ Health care service resource use including hospitalization costs, monthly (2020 CAD)d • Physician costs, annual (2018 CAD)c ○ Physician costs, monthly (2020 CAD)d |
2,832 (STD: 7,601; SE: 12.36)c,f 527 (STD: 2,101; SE: 3.42)c 122.86 (0.58)/44.93 (0.29)d 1,701 (STD: 6,623; SE: 10.77)c 145.02 (0.92)d 605 (STD: 737; SE: 1.20)c 51.58 (0.10)d |
– – Gamma (α: 44,984.200; λ : 366.156)/Gamma (α: 23,793.824; λ : 529.571) – Gamma (α: 24,945.616; λ : 172.013) – Gamma (α: 254,841.929; λ : 4,940.672) |
Tanner et al, 201987; Tanner et al, 202078 – – – – – – |
| No remission (or relapse), total annual costs (2018 CAD) • Medication (prescription drug) costs, annual (2018 CAD)c ○ Medication costs, monthly (2020 CAD) |
10,064 (STD: 41,113; SE: 94.30)c,g 1,441 (STD: 2,962; SE: 6.79)c 122.86 (0.58)d |
– – Gamma (α: 44,984.200; λ : 366.156) |
Tanner et al, 201987; Tanner et al, 202078 – – |
| • Health care service resource use and hospitalization costs, monthly (2018 CAD) ○ Health care service resource use and hospitalization costs, monthly (2020 CAD) • Physician costs, annual (2018 CAD) ○ Physician costs, monthly (2020 CAD) |
7,192 (STD: 38,761; SE: 88.91)c 613.17 (7.58)d 1,431 (STD: 3,282; SE: 7.53)c 122.00 (0.64)d |
– Gamma (α: 6,543.522; λ : 10.672) – Gamma (α: 36,133.020; λ : 296.166) |
– – – – |
| Welle • Medication (prescription drug) costs, annual (2018 CAD)c ○ Medication costs, monthly (2020 CAD) • Physician costs, annual ○ Physician costs, monthly (2020 CAD) |
– 527 (STD: 2,101; SE: 3.42)c 44.93 (0.29)d – 47.70 |
– – Gamma (α: 23,793.824; λ : 529.571) – NA (fixed) |
– Tanner et al, 201987 – – OHIP code K033113 |
Abbreviations: NA, not applicable; OHIP, Ontario Health Insurance Plan; SE, standard error; STD, standard deviation.
Estimates of standard error were calculated from observed published data whenever possible; otherwise, SEs are assumed to be 25% of mean cost (e.g., cost of testing, SE=$625).
For inputs with calculated SEs, we assigned gamma distributions in probabilistic analysis. Two parameters of the gamma distribution (α, λ) are derived from the mean and SE. Formulas for these calculations are: α = (Mean2)/(SE2); λ = Mean/([Mean × SE]2).
Cost estimates are presented in this table as reported in the original paper (2018 CAD)87; SEs were calculated from the reported standard deviations and sample sizes (SE = STD/√(N), where N for the cohort of patients with depression was 190,065 and for the cohort of patients without depression was 378,177).87
To estimate cost per model cycle length of 1 month, we first inflated estimates from 2018 CAD to 2020 CAD using the Canadian Consumer Price Index (CPI).114 (137.4 [2020]/134.3 [2018]): for example, in no remission, annual cost of prescription drug was $1,441 in 2018 CAD, and was converted to $1,474 in 2020 CAD. Next, inflation-adjusted annual cost was transformed into the monthly estimate: $1474/12 = $123.
Well health state was included in a scenario analysis only.
Mean health care services utilization per year (a person without depression) was 8.5 (STD: 8.8) physician visits; 5.0 (STD: 5.2) family doctor visits; 3.5 (STD: 5.9) visits with a specialist; 0.1 (STD:0.5) sessions of psychotherapy; 0.1 (STD: 0.3) hospitalizations; 1.9 (STD: 8.3) days in hospital; 0.4 (STD: 3.5) days in intensive care unit; 0.1 (STD: 0.4) emergency department admissions; and 4.2 (29.5) days receiving long-term care (original article,87 Table 4).
Mean health care services utilization yearly (a person with depression) was 18.6 (STD: 27.8) physician visits; 11.0 (STD: 15.0) family doctor visits; 7.6 (STD: 19.4) visits with a specialist; 1.7 (STD: 4.7) sessions of psychotherapy; 0.5 (STD: 4.1) hospitalizations; 8.3 (STD: 40.5) days in hospital; 0.7 (STD: 0.5) days in intensive care unit; 0.4 (STD: 2.6) emergency department admissions; and 16.0 (61.2) days receiving long-term care (original article,87 Table 4).