| A | B | C | D | E | |
|---|---|---|---|---|---|
1 | Variable | Value | Unit | Source | Notes |
2 | Scale | ||||
3 | Percentage of sufferers of BSD in the US (12-month) | 2.20% | https://pubmed.ncbi.nlm.nih.gov/21383262/ | ||
4 | UK population | 67.2E+6 | https://pubmed.ncbi.nlm.nih.gov/21383262/ | ||
5 | Number of sufferers of BSD in the UK | 1.5E+6 | I couldn't find any data on the percentage of sufferers of BSD in the UK, so I used the US data. | ||
6 | Average time until correct diagnosis | 7.5 | years | https://pubmed.ncbi.nlm.nih.gov/10357026/ | |
7 | Average fraction of time spent depressed | 0.3 | https://pubmed.ncbi.nlm.nih.gov/12507734/ | ||
8 | QALY loss while depressed (per year) | 0.5 | https://pubmed.ncbi.nlm.nih.gov/25660550/ | ||
9 | QALY loss before correct treatment (per year) | 0.15 | |||
10 | QALY loss before correct diagnosis for one patient | 1.125 | |||
11 | Total QALY loss before correct diagnosis in the UK | 1.7E+6 | |||
12 | |||||
13 | Tractability | ||||
14 | Percentage of sufferers of depression in developed countries (12-month) | 5.50% | https://cks.nice.org.uk/topics/depression/background-information/prevalence/#:~:text=The%20average%20lifetime%20prevalence%20estimate,adults%20in%20high%2Dincome%20countries. | ||
15 | Number of patients with depression (including BSD) in the UK | 3.7E+6 | |||
16 | Patients experiencing intervention who would be correctly identified as bipolar | 24% | See separate sheet (Intervention Statistics) | ||
17 | Patients experiencing intervention who would be incorrectly identified as bipolar | 7% | See separate sheet (Intervention Statistics) | ||
18 | Delay of treatment for false positives | 0.25 | years | It is obvious if lamotrigine was effective within a couple of months. | |
19 | QALY loss due to treatment delay for false positives | 33.7E+3 | |||
20 | Percentage of patients who recover on correct diagnosis (and treatment with lamotrigine) | 10% | https://pubmed.ncbi.nlm.nih.gov/19118318/ | This is a guesstimate based on the best meta-analysis available, which still seems insufficient. Overall, perhaps the first step to the success of this intervention would be gathering more evidence in support of lamotrigine, but the cost involved may render it no longer cost-effective. | |
21 | QALYs gained due to correct diagnosis and treatment in true positives | 101.1E+3 | |||
22 | Net QALYs gained due to intervention (in the UK) | 67.3E+3 | |||
23 | |||||
24 | Cost | ||||
25 | Salary for a person advocating for policy change and conducting the intervention | £30,000.00 | GBP | ||
26 | Number of GPs in the UK | 36752 | https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/pressures-in-general-practice-data-analysis | ||
27 | Cost of printing and sending educational materials to one GP | 5 | GBP | pessimistic estimate | |
28 | Total cost | £213,760.00 | GBP | ||
29 | Total cost in dollars | 237,273.60 | USD | ||
30 | |||||
31 | Total cost effectiveness for intervention within the UK | 0.28 | QALY/dollar |