19 - Economic Feasibility Of Two Digital Health-Based Depression Prevention Programs For Adolescents In Primary Care Practices

Publication Number: 3017.19

Lestin T. Kandakudy, University of Illinois College of Medicine, Woodridge, IL, United States; Calvin Rusiewski, University of Illinois College of Medicine, Chicago, IL, United States; Shion Kabasele, University of Illinois Chicago, Chicago, IL, United States; Kenneth A. Rasinski, University of Illinois at Chicago, Chicago, IL, United States; Helene Gussin, University of Illinois Chicago, Chicago, IL, United States; Patrick Pössel, University of Louisville, Louisville, KY, United States; Cheryl Lefaiver, Advocate Children's Hospital - Oak Lawn, Oak Lawn, IL, United States; Michael Gerges, University of Illinois College of Medicine, Chicago, IL, United States; Tracy Gladstone, Brown University, Providence, RI, United States; Benjamin VanVoorhees, University of Illinois, Chicago, IL, United States

Background: Depression is a leading cause of disability among youth and contributes to an estimated annual economic burden of $326 billion in the United States. Preventive digital health interventions (DHIs), such as Competent Adulthood Transition with Cognitive-Behavioral, Humanistic, and Interpersonal Training (CATCH-IT), aim to bridge the gap between evidence-based therapy modalities and scalable care for adolescents. While CATCH-IT demonstrates clinical promise, implementation success depends not only on efficacy but also on cost feasibility. Previous studies have evaluated the costs of DHIs for adults with depression; however, few have assessed the economic feasibility of DHIs for adolescents with depression.

Objective: To quantify the development, delivery, and recruitment costs of CATCH-IT and Teens Achieving Mastery Over Stress (TEAMS), a group-based cognitive-behavioral prevention program, using data from the PATH 2 Purpose (P2P) clinical trial, in order to assess their economic feasibility in primary care practices.

Design/Methods: P2P evaluated the comparative effectiveness of two adolescent evidence-based depression prevention interventions, CATCH-IT and TEAMS. 536 adolescents were enrolled with sub-clinical depressive symptoms from six healthcare systems and over 50 individual healthcare sites in Illinois and Kentucky. Participants were cluster-randomized and followed for 18 months by online surveys and telephone interviews. A descriptive cost analysis of P2P financial reports was conducted. Costs were categorized as development, delivery, or recruitment. Research-related expenses were excluded to reflect real-world implementation. Per-adolescent delivery and recruitment costs were calculated using trial-size numbers. Per-adolescent development costs were spread across a hypothetical 5,000 Accountable Care Organization population.

Results: Development costs were $509,860.97 for CATCH-IT ($101.97 per-adolescent) and $197,942.38 for TEAMS ($39.59 per-adolescent). Delivery costs were $62,136.68 for CATCH-IT ($155.73 per-adolescent; n = 399) and $191,248.36 for TEAMS ($806.96 per-adolescent; n = 237). Recruitment costs were $778,022.03 for CATCH-IT ($2,903.07 per-adolescent) and $657,338.55 for TEAMS ($2,785.33 per-adolescent).

Conclusion(s): CATCH-IT required a greater initial investment in digital infrastructure and content development, but yielded lower delivery costs, whereas TEAMS incurred higher delivery costs due to clinician-led group sessions. These findings suggest that CATCH-IT may represent a cost-feasible approach in preventing adolescent depression in primary care practices.

Development Cost of CATCH-IT and TEAMS
Total development cost components for CATCH-IT and TEAMS, categorized by indirect, intervention infrastructure, consulting/marketing, and content development expenditures

Delivery Cost of CATCH-IT and TEAMS
Total delivery cost components for CATCH-IT and TEAMS, categorized by indirect, safety, and intervention infrastructure expenditures.

Per-Adolescent Cost of CATCH-IT and TEAMS
Total and per-adolescent development, delivery, and recruitment costs for CATCH-IT and TEAMS.