Health Economic Evaluation of Cognitive Control Training for Depression: Key Considerations (Preprint)

Abstract

UNSTRUCTURED Depression is a serious and burdensome psychiatric illness that contributes heavily to health expenditures. These costs are partly related to the observation that depression is often not limited to a single episode but can recur or follow a chronic pathway. In terms of risk factors, it is acknowledged that cognitive impairments play a crucial role in depression vulnerability. Within this context, cognitive remediation – among which cognitive control training (CCT) specifically – has shown its effectiveness in reducing risk for recurrence of depression. CCT is low-cost intensive and can be provided online which makes it easy to disseminate. Despite increasing interest in the field, studies examining the cost-effectiveness of CCT in the context of depression are largely missing. Health-economic evaluation (HEE) allows to inform decision makers with evidence-based insights on how to spend limited available (financial) resources in the most efficient way. HEE studies constitute a crucial step to implementing a new intervention in clinical practice. Approaching preventive measures for depression such as CCT from a HEE perspective would be informative to health policy, fostering optimal use of health expenditures. The scope of this review is to inform and guide researchers during the phase of designing HEE studies in the context of CCT for depression. A clear view on CCT cost-effectiveness is paramount to its clinical implementation.