Background Depressive disorders are associated with a high burden of disease. However, due to the burden posed by the disease on not only the sufferers, but also on their relatives, there is an ongoing debate about which costs to include and, hence, which perspective should be applied. Therefore, the aim of this paper was to examine whether the change between healthcare payer and societal perspective leads to different conclusions of cost-utility analyses in the case of depression. Methods A systematic literature search was conducted to identify economic evaluations of interventions in depression, launched on Medline and the Cost-Effectiveness Registry of the Tufts University using a ten-year time horizon (2008–2018). In a two-stepped screening process, cost-utility studies were selected by means of specified inclusion and exclusion criteria. Subsequently, relevant findings was extracted and, if not fully stated, calculated by the authors of this work. Results Overall, 53 articles with 92 complete economic evaluations, reporting costs from healthcare payer/provider and societal perspective, were identified. More precisely, 22 estimations (24%) changed their results regarding the cost-effectiveness quadrant when the societal perspective was included. Furthermore, 5% of the ICURs resulted in cost-effectiveness regarding the chosen threshold (2% of them became dominant) when societal costs were included. However, another four estimations (4%) showed the opposite result: these interventions were no longer cost-effective after the inclusion of societal costs. Conclusions Summarising the disparities in results and applied methods, the results show that societal costs might alter the conclusions in cost-utility analyses. Hence, the relevance of the perspectives chosen should be taken into account when carrying out an economic evaluation. This systematic review demonstrates that the results of economic evaluations can be affected by different methods available for estimating non-healthcare costs.

中文翻译：

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在经济评估中考虑社会视角：在抑郁症的情况下进行系统回顾。

背景技术抑郁症与疾病的高负担有关。然而，由于该疾病不仅给患者而且对他们的亲属造成负担，因此，关于包括哪些费用以及应该采用哪种观点的争论一直在进行。因此，本文的目的是检验在抑郁症患者中，医疗支付者和社会观点之间的变化是否导致成本效用分析的不同结论。方法采用十年时间范围（2008-2018年），在Medline和塔夫茨大学成本效益登记处进行了系统的文献检索，以确定抑郁症干预措施的经济评价。在两步筛选过程中，通过指定的包含和排除标准选择了成本－效用研究。随后，本研究的作者提取了相关发现，如果没有充分说明，则进行计算。结果总共确定了53篇文章，其中92篇文章对经济进行了完整的经济评估，从医疗保健付款人/提供者和社会角度报告了成本。更准确地说，当纳入社会观点时，有22个估计（占24％）改变了其关于成本效益象限的结果。此外，当包括社会成本时，有5％的ICUR产生了与所选阈值有关的成本效益（其中2％占主导）。但是，另外四个估计（4％）显示了相反的结果：这些干预措施在计入社会成本后不再具有成本效益。结论总结了结果和应用方法之间的差异，结果表明，社会成本可能会改变成本效用分析的结论。因此，进行经济评估时应考虑所选观点的相关性。这项系统的评估表明，经济评估的结果可能会受到可用于估算非医疗保健费用的不同方法的影响。