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Cheap EnoughPeer-ReviewedJournal of Consulting and Clinical Psychology2021
Economic evaluation of an online single-session intervention
Economic Evaluation of an Online Single-Session Intervention for Depression in Kenyan Adolescents
Key Finding
An economic evaluation found that delivering Shamiri-Digital costs $3.57 per student, with only $25.35-$34.62 needed per student for clinically meaningful improvements in depression.
At a Glance
Study Design
RCT economic analysis
Sample Size
N=103
Population
Kenyan high school students
Setting
Kenya
Abstract
Objective: To evaluate the costs and cost-effectiveness of Shamiri-Digital, an online single-session intervention (SSI) for depression among Kenyan adolescents.
Method: Data were drawn from a randomized clinical trial with n = 103 Kenyan high school students (64% female, Mage = 15.5). All students were eligible to participate, regardless of baseline depression symptomatology. We estimated delivery costs in 2020 U.S. dollars from multiple perspectives. To account for uncertainty, we performed sensitivity analyses with different cost assumptions and definitions of effectiveness. Using number needed to treat (NNT) estimates, we also evaluated the cost required to achieve a clinically meaningful reduction in depressive symptoms.
Results: In the base-case (the most realistic cost estimate), it costs U.S. $3.57 per student to deliver Shamiri-Digital. Depending on the definition of clinically meaningful improvement, 7.1–9.7 students needed to receive the intervention for one student to experience a clinically meaningful improvement, which translated to a cost of U.S. $25.35 to U.S. $34.62 per student. Under a worst-case scenario (i.e., assuming the highest treatment cost and the strictest effectiveness definition), the cost to achieve clinically meaningful improvement was U.S. $92.05 per student.
Conclusions: Shamiri-Digital is a low-cost intervention for reducing depression symptomatology. The public health benefit of empirically supported SSIs is especially important in low-income countries, where funding for mental health care is most limited.
Method: Data were drawn from a randomized clinical trial with n = 103 Kenyan high school students (64% female, Mage = 15.5). All students were eligible to participate, regardless of baseline depression symptomatology. We estimated delivery costs in 2020 U.S. dollars from multiple perspectives. To account for uncertainty, we performed sensitivity analyses with different cost assumptions and definitions of effectiveness. Using number needed to treat (NNT) estimates, we also evaluated the cost required to achieve a clinically meaningful reduction in depressive symptoms.
Results: In the base-case (the most realistic cost estimate), it costs U.S. $3.57 per student to deliver Shamiri-Digital. Depending on the definition of clinically meaningful improvement, 7.1–9.7 students needed to receive the intervention for one student to experience a clinically meaningful improvement, which translated to a cost of U.S. $25.35 to U.S. $34.62 per student. Under a worst-case scenario (i.e., assuming the highest treatment cost and the strictest effectiveness definition), the cost to achieve clinically meaningful improvement was U.S. $92.05 per student.
Conclusions: Shamiri-Digital is a low-cost intervention for reducing depression symptomatology. The public health benefit of empirically supported SSIs is especially important in low-income countries, where funding for mental health care is most limited.
Authors
Wasil, A. R., Kacmarek, C. N., Osborn, T. L., Palermo, E. H., DeRubeis, R. J., Weisz, J. R., Yates, B. T.
Citation & Access
Wasil, A. R., Kacmarek, C. N., Osborn, T. L., Palermo, E. H., DeRubeis, R. J., Weisz, J. R., Yates, B. T. (2021). Economic Evaluation of an Online Single-Session Intervention for Depression in Kenyan Adolescents. Journal of Consulting and Clinical Psychology.