Evidence map›Paper›PMID 41083989›Full record

Trial reportBMC psychiatry2025

Cost-utility analysis of a collaborative and stepped care model in patients with mental disorders in German primary care (the COMET study).

Thomas Grochtdreis, Daniela Heddaeus, Tharanya Seeralan, Kerstin Maehder, Sarah Porzelt, Anne Daubmann, Amra Pepic, Bernd Löwe, Moritz Rosenkranz, Ingo Schäfer and 12 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03226743 (Collaborative and Stepped Care in Mental Health by Overcoming Treatment Sector Barriers), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03226743 nacompletednot on this map

Collaborative and Stepped Care in Mental Health by Overcoming Treatment Sector Barriers: A Cluster-randomized Controlled Trial (COMET)

TypeinterventionalSponsorUniversitätsklinikum Hamburg-EppendorfRan2018 to 2022Enrolled615ConditionsDepressive Disorder, Anxiety Disorder, Somatoform Disorder, Alcohol Use DisorderArmscollaborative and stepped care model
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Thomas GrochtdreisDepartment of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. t.grochtdreis@gmail.com.
Daniela HeddaeusDepartment of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Tharanya SeeralanDepartment of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Kerstin MaehderDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Sarah PorzeltDepartment of General Practice and Primary Care, University Medical Center Hamburg- Eppendorf, Hamburg, Germany.
Anne DaubmannDepartment of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Amra PepicDepartment of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Bernd LöweDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Moritz RosenkranzCenter for Interdisciplinary Addiction Research, University of Hamburg; Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Ingo SchäferCenter for Interdisciplinary Addiction Research, University of Hamburg; Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Martin SchererDepartment of General Practice and Primary Care, University Medical Center Hamburg- Eppendorf, Hamburg, Germany.
Bernd SchulteCenter for Interdisciplinary Addiction Research, University of Hamburg; Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Olaf von dem KnesebeckDepartment of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Angelika WeigelDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Karl WegscheiderDepartment of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Silke WernerDepartment of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Antonia ZapfDepartment of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Thomas ZimmermannDepartment of General Practice and Primary Care, University Medical Center Hamburg- Eppendorf, Hamburg, Germany.
Jörg DirmaierDepartment of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Martin HärterDepartment of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Hans-Helmut König *Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Judith Dams *Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn order to reduce the health burden and the health care costs caused by the most common mental disorders, health care systems throughout Europe have tried to improve services and treatment choices. Recently, a collaborative and stepped care (CSC) model for patients with depressive, anxiety, somatoform or alcohol-related disorders and their comorbidities was developed and implemented under routine care conditions in Germany. The aim of this study was to determine the cost-effectiveness of this CSC model from a societal perspective with a 12-month follow-up.

methodsThis study was part of a cluster-randomized controlled trial to compare a CSC model with treatment as usual (TAU) in patients with depressive, anxiety, somatoform or alcohol-related disorders and their comorbidities in German routine care. The cost-effectiveness of the CSC model compared with TAU was analyzed based on the incremental cost-utility ratio (ICUR) with quality-adjusted life years (QALYs) based on the EQ-5D-5L index as measure of health effect. The uncertainty of the ICUR was assessed using cost-effectiveness acceptability curves based on net-benefit regressions.

resultsIn total, n = 307 patients in the CSC and n = 308 patients in the TAU group were included, with a mean age of 38 and 43 years, respectively. There were no differences in mean QALYs and total costs between the CSC (0.86 QALY, 27,174€) and the TAU group (0.86 QALY, 26,441€). Only the adjusted mean costs for outpatient mental health services were higher in the CSC group (+685€; 95% CI 398€ to 972€; p < 0.001). The probability of cost-effectiveness of the CSC model was 35% at a willingness-to-pay (WTP) of 0€ and 34% at a WTP of 50,000€ per additional QALY.

conclusionThe evaluated CSC model was unlikely to be cost-effective compared with TAU from a societal perspective for patients with depressive, anxiety, somatoform or alcohol-related disorders and their comorbidities during the 12-month follow-up period. The higher mean costs for outpatient mental health services might indicate that general practitioners in the CSC group were able to refer patients to psychotherapists and psychiatrists more frequently through the network of health care providers.

trial registrationClinicalTrials.gov: NCT03226743. Registration date: 24/7/2017.

Indexed as

Cost-Benefit AnalysisMental DisordersPrimary Health CareAdultAnxiety DisordersComorbidityFemaleGermanyHealth Care CostsHumansMaleMiddle AgedQuality-Adjusted Life YearsSomatoform DisordersAlcohol-related disordersAnxiety disordersCollaborative careCost-effectiveness analysisDepressive disordersPrimary careSomatoform disordersStepped care

Identifiers

PMID41083989
PMCPMC12516892

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.