Spending an hour in talk therapy with a trained counselor costs much more, and takes more time, than swallowing an inexpensive antidepressant pill.
But in a new study, researchers found that for people with a new diagnosis of major depression, the costs and benefits of the two approaches end up being equal after five years.
The analysis used real-world data on treatment costs and showed positive and negative health effects, and impacts of treatment and depression symptoms on productivity.
It could help guide future care and insurance coverage.
The research was conducted by a team at Michigan Medicine and Harvard University.
National physician groups such as the American College of Physicians endorse giving people newly diagnosed with depression the option to choose either approach.
But this would mean expanding the capacity of the healthcare system to provide greater access to psychotherapy than is currently available.
Making CBT more available could save money for the companies and government agencies that pay for depression care – including by giving patients more depression-free time leading to improved performance at work.
The team says that one might assume that antidepressants are more cost-effective than psychotherapy because they don’t require travel time, time away from work, and as many contacts with providers as therapy does.
But when incorporating the long-term effectiveness of each treatment, they found that neither treatment is consistently superior to the other.
Since CBT and antidepressants are roughly equivalent from a health-economic perspective, other factors should determine what treatment an individual patient receives – and the most important factor is the patient’s values and preferences.
The team suggests that more people newly diagnosed with depression should have a chance to try individual and group sessions of cognitive-behavioral therapy, or CBT, as their first treatment, if they would prefer therapy overtaking an antidepressant medication.
The lead author of the study is Eric L. Ross, M.D., a psychiatrist at Harvard Medical School.
The study is published in the Annals of Internal Medicine.
Copyright © 2019 Knowridge Science Report. All rights reserved.
