Table A33:
Costs and Resource Use Inputs in Economic Model, Additional Information
| Variable | Unit Cost, $ Mean (SE)a | Frequency (Number)f,g | Total Costs, $ Mean (SE)a | Distribution (Parameters)b | Reference |
|---|---|---|---|---|---|
| Multi-gene Pharmacogenomic Testing (One-Time Cost) | |||||
| Testing including sample transportation costs | 2,500 (625) | 1 | 2,500 (625) | Gamma (α: 16; λ : 0.0064) | Tanner et al, 202078 |
| Physician costs (2 visits) | 67.75 | 2 | 135.5 | 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 mo/Rest of follow-upd • Health care service resource use and hospitalization costs, annual (2018 CAD)c,f ○ Health care service resource use including hospitalization costs, monthly (2020 CAD) d,f |
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,f – – – 145.02 (0.92)d,f – |
NA 1 1 Hospitalizations: 0.1 (1.9 d in hospital and 0.4 d in ICU) ED admissions: 0.1 Long-term care, d: 4.2 – Hospitalizations: 0.1/12 ED admissions: 0.1/12 |
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 – – – 1645.02 (0.92)d – |
NA NA Gamma (α: 44,984.200; λ : 366.156)/Gamma (α: 23,793.824; λ : 529.571) NA – – – Gamma (α: 24,945.616; λ : 172.013) – |
Tanner et al, 201987; Tanner et al, 202078 – – – – – – – – |
| • Physician costs, annual (2018 CAD)c,f ○ Physician costs, monthly (2020 CAD)d,f |
– – 605 (STD: 737; SE: 1.20)c,f 51.58 (0.10)d,f |
Long-term care, d: 4.2/12 – Physician visits: 8.5 (family doctor visits: 5.0; specialist visits: 3.5; psychotherapy sessions: 0.1) Physician visits: 8.5/12 |
– – 605 (STD: 737; SE: 1.20)c 51.58 (0.10) d |
– – NA Gamma (α: 254,841.929; λ : 4,940.672) |
– – – – |
| No remission (or relapse), total annual costs (2018 CAD) • Medication (prescription drug) costs, annual (2018 CAD)c,g ○ Medication costs, monthly (2020 CAD) • Health care service resource use and hospitalization costs, monthly (2018 CAD)c,g ○ Health care service resource use and hospitalization costs, monthly (2020 CAD)d,g |
10,064 (STD: 41,113; SE: 94.30)c,g 1,441 (STD: 2,962; SE: 6.79)c 122.86 (0.58)d 7,192 (STD: 38,761; SE: 88.91)c,g – – 613.17 (7.58)d,g – |
1 1 1 Hospitalizations: 0.5 (8.3 d in hospital; 0.7 d in ICU) ED admissions: 0.4 Long-term care, d: 16 Hospitalizations: 0.5/12 ED admissions: 0.4/12 |
10,064 (STD: 41,113; SE: 94.30)c,g 1,441 (STD: 2,962; SE: 6.79)c 122.86 (0.58)d 7,192 (STD: 38,761; SE: 88.91)c – – 613.17 (7.58)d – |
NA NA Gamma (α: 44,984.200; λ : 366.156) NA – – Gamma (α: 6,543.522; λ : 10.672) – |
Tanner et al, 201987; Tanner et al, 202078 – – – – – – – |
| • Physician costs, annual ○ Physician costs, monthly (2020 CAD) |
— 1,431 (STD: 3,282; SE: 7.53)c,g 122.00 (0.64)d,g |
Long-term care, d: 16/12 Physician visits: 18.6 (family doctor visits: 11.0; specialist visits: 7.6; psychotherapy sessions: 1.7) Physician visits: 18.6/12 |
— 1,431 (STD: 3,282; SE: 7.53)c 122.00 (0.64)d,g |
— — Gamma (α: 36,133.020; λ : 296.166) |
— — — |
| Welle • Medication (prescription drug) costs, annual (2018 CAD)c ○ Medication costs, per month (2020 CAD) • Physician costs ○ Physician costs, monthly (2020 CAD) |
— 527 (STD: 2,101; SE: 3.42)c 44.93 (0.29) d — 47.70 |
— 1 1 — 1 |
— 527 (STD: 2,101; SE: 3.42)c 44.93 (0.29)d — 47.70 |
— NA Gamma (α: 23,793.824; λ : 529.571) – NA (fixed) |
— Tanner et al, 201987 — — OHIP code K033113 |
Abbreviations: ED, emergency department; ICU, intensive care unit; NA, not applicable; OHIP, Ontario Health Insurance Plan; SE, standard error; STD, standard deviation.
Estimates of SEs 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 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 the table as reported in the original paper (2018 CAD)87; SEs were calculated from reported standard deviations and sample sizes (SE = STD/√) where n for the cohort of patients with depression was 190,065 and n for the cohort of patients without depression was 378,177).87
To estimate the cost for the 1-month model cycle, we first inflated the estimates from 2018 CAD to 2020 CAD using the Canadian Consumer Price Index114: (137.4 [2020]/134.3 [2018]): for example, in no remission, the annual cost of prescription drug was $1,441 in 2018 CAD and was converted to $1,474 in 2020 CAD. Next, the inflation-adjusted annual cost was transformed into the monthly estimate: $1,474/12 = $123.
Well health state was included in a scenario analysis only.
Mean health care services utilization yearly (for 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 ICU; 0.1 (STD: 0.4) ED admissions; and 4.2 (STD: 29.5) days receiving long-term care (original article,87 Table 4).
Mean health care services utilization yearly (for 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 ICU; 0.4 (STD: 2.6) ED admissions; and 16.0 (STD: 61.2) days receiving long-term care (original article, 87 Table 4).