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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

SO009

Cost-utility of intravenous ketamine versus electroconvulsive therapy for moderate and severe depression: a real-world economic evaluation from India

COST–UTILITY OF INTRAVENOUS KETAMINE VERSUS ELECTROCONVULSIVE THERAPY FOR MODERATE TO SEVERE DEPRESSION: A REAL-WORLD ECONOMIC EVALUATION FROM INDIA

In real-world tertiary care settings in India, intravenous ketamine demonstrated more favorable cost-utility than electroconvulsive therapy (ECT) over short-term follow-up.

The aim of the study was to compare the societal cost per quality-adjusted life year (QALY) gained with intravenous ketamine versus electroconvulsive therapy (ECT) for the treatment of depression in a tertiary care setting in India. A prospective economic evaluation was conducted at a public tertiary care hospital; adult patients with moderate-to-severe depression referred for ECT or intravenous ketamine were followed from baseline to 1 month after treatment completion. Of 52 patients screened, 33 were consecutively enrolled and included in the analysis (ketamine arm, n = 18; ECT arm, n = 15). Depression severity was assessed using the HDRS and PHQ-9, and health-related quality of life using the EQ-5D-5L, at baseline and follow-up. Costs were calculated from a societal perspective by combining patient/caregiver expenditures with hospital costs estimated using time-driven activity-based costing (TDABC). The mean change in HDRS score was slightly greater in the ECT arm than in the ketamine arm (mean 20.4 versus 19.34), and the mean QALY gain per patient at 1 month was also greater in the ECT arm (0.032 versus 0.024); the table in the poster reported mean QALY values of 0.080 (SD 0.001) in the ketamine arm and 0.078 (SD 0.002) in the ECT arm, with a statistically significant difference (t = 2.0; p = 0.05). However, the societal cost per QALY gained was approximately 3 times higher for ECT than for ketamine (INR 2,975,895 versus INR 956,556). The societal cost per unit reduction in HDRS score was also approximately 3.8 times higher for ECT (INR 4,668 versus INR 1,187). In conclusion, although ECT was marginally superior in terms of symptom improvement and QALY gains, these gains were achieved at a substantially higher cost. Ketamine may be a more cost-effective option in resource-limited settings, and long-term studies are needed to determine whether its economic advantage is sustained.

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