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Table 1 Model parameters and output under hypothetical usual care and four scenarios of improvement above baseline

From: A simple filter model to guide the allocation of healthcare resources for improving the treatment of depression among cancer patients

Model Parameters Baseline Scenario 1: Increase detection Scenario 2: Increase provider response Scenario 3: Increase patient acceptance Scenario 4: Increase treatment effectiveness
Population
Arbitrary population of cancer patients 10,000 10,000 10,000 10,000 10,000
Target group
Cancer patients with depression 15% n = 55,500 15% n = 55,500 15% n = 55,500 15% n = 55,500 15% n = 55,500
Filter 1: detection
Detection (description) Clinician judgement Computerised short screening tool Clinician judgement Clinician judgement Clinician judgement
% and no. detected 20% n = 300 35% n = 525 20% n = 300 20% n = 300 20% n = 300
Cost for detection (per person) $5 $10.00 $5 $5 $5
Total cost for filter 1 $7500 $15,000 $7500 $7500 $7500
Filter 2: Provider response
Provider response (description) Clinician judgement Clinician judgement Provision of patient distress screening scores and recommendation to clinician Clinician judgement Clinician judgement
% and no. offered treatment 70% n = 210 70% n = 368 85% n = 255 70% n = 210 70% n = 210
Cost for provider (per person) $5 $5 $10 $5 $5
Total cost for filter 2 $1500 $2625 $3000 $1500 $1500
Filter 3: Patient acceptance
Patient acceptance (description) Patient judgement Patient judgement Patient judgement Distress scores & recommendation provided to patient Patient judgement
% and no. accept treatment 30% n = 63 30% n = 110 30% n = 77 45% n = 95 30% n = 63
Cost for acceptance (per person) $0 $0 $0 $7.50 $0
Total cost for filter 3 $0 $0 $0 $1575 $0
Filter 4: Treatment efficacy
Treatment (description) Referral to primary care Referral to primary care Referral to primary care Referral to primary care Collaborative care model
Treatment outcome No longer meets diagnostic criteria for depression No longer meets diagnostic criteria for depression No longer meets diagnostic criteria for depression No longer meets diagnostic criteria for depression No longer meets diagnostic criteria for depression
% and no. treated successfully 30% n = 19 30% n = 33 30% n = 23 30% n = 28 45% n = 28
Cost for treatment (per person) $100 $100 $100 $100 $300
Total cost for filter 4 $6300 $11,025 $7650 $9450 $18,900
Outcome metrics
Total cost $15,300 $28,650 $18,110 $20,025 $27,900
Cost per patient receiving care $242.86 $260 $237 $212 $443
Cost per successful outcome $810 $866 $791 $706 $984
Incremental total cost compared to baseline n/a $13,350 $2850 $4725 $12,600
Incremental number of patients successfully treated compared to baseline n/a 14 4 9 9
ICER n/a $942 $704 $500 $1333
Policy Advice n/a Compared to usual care this scenario is MORE EXPENSIVE and has BETTER EFFECTIVENESS Compared to usual care this scenario is MORE EXPENSIVE and has BETTER EFFECTIVENESS Compared to usual care this scenario is MORE EXPENSIVE and has BETTER EFFECTIVENESS Compared to usual care this scenario is MORE EXPENSIVE and has BETTER EFFECTIVENESS
  1. Data in bold indicate key changes to the filter input data under the four scenarios