{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:52:55Z","timestamp":1784555575327,"version":"3.55.0"},"reference-count":44,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,12,22]],"date-time":"2024-12-22T00:00:00Z","timestamp":1734825600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Psychiatr Scand"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although repetitive transcranial magnetic stimulation (rTMS) is an effective and commonly used treatment option for treatment\u2010resistant depression, its cost\u2010effectiveness remains much less studied. In particular, the comparative cost\u2010effectiveness of rTMS and other treatment options, such as antidepressant medication, has not been investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An economic evaluation with 12 months follow\u2010up was conducted in the Dutch care setting as part of a pragmatic multicenter randomized controlled trial, in which patients with treatment\u2010resistant depression were randomized to treatment with rTMS or treatment with the next pharmacological step according to the treatment algorithm. Missing data were handled with single imputations using predictive mean matching (PMM) nested in bootstraps. Incremental cost\u2010effectiveness and cost\u2010utility ratios (ICERs\/ICURs) were calculated, as well as cost\u2010effectiveness planes and cost\u2010effectiveness acceptability curves (CEACs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Higher QALYs, response, and remission rates were found for lower costs when comparing the rTMS group to the medication group. After 12 months, QALYs were 0.618 in the rTMS group and 0.545 in the medication group. The response was 27.1% and 24.4% and remission was 25.0% and 17.1%, respectively. Incremental costs for rTMS were \u2212\u20ac2.280, resulting in a dominant ICUR for QALYs and ICER for response and remission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>rTMS appears to be a cost\u2010effective treatment option for treatment\u2010resistant depression when compared to the next pharmacological treatment step. The results support the implementation of rTMS as a step in the treatment algorithm for depression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>The trial is registered within the Netherlands Trial Register (code: NL7628, date: March 29, 2019)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acps.13782","type":"journal-article","created":{"date-parts":[[2024,12,22]],"date-time":"2024-12-22T19:01:36Z","timestamp":1734894096000},"page":"613-624","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Cost\u2010Effectiveness of\n                    <scp>rTMS<\/scp>\n                    as a Next Step in Antidepressant Non\u2010Responders: A Randomized Comparison With Current Antidepressant Treatment Approaches"],"prefix":"10.1111","volume":"151","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7539-6498","authenticated-orcid":false,"given":"Iris","family":"Dalhuisen","sequence":"first","affiliation":[{"name":"Department of Psychiatry Radboud University Medical Center  Nijmegen The Netherlands"},{"name":"Donders Institute for Brain Cognition and Behavior Centre for Medical Neuroscience  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Bui","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Faculty of Earth and Life Sciences VU University  Amsterdam The Netherlands"},{"name":"Center for Economic Evaluation, Trimbos Institute \u2013 Netherlands Institute of Mental Health and Addiction  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Kleijburg","sequence":"additional","affiliation":[{"name":"Center for Economic Evaluation, Trimbos Institute \u2013 Netherlands Institute of Mental Health and Addiction  Utrecht The Netherlands"},{"name":"Department of Health Services Research, CAPHRI Care and Public Health Research Institute Maastricht University  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris","family":"van Oostrom","sequence":"additional","affiliation":[{"name":"Neurocare Clinics  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Spijker","sequence":"additional","affiliation":[{"name":"Depression Expertise Centre, Pro Persona Mental Health Care  Nijmegen The Netherlands"},{"name":"Behavioral Science Institute Radboud University  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"van Exel","sequence":"additional","affiliation":[{"name":"GGZ inGeest Specialized Mental Health Care  Amsterdam The Netherlands"},{"name":"Department of Psychiatry Amsterdam University Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"van Mierlo","sequence":"additional","affiliation":[{"name":"Department of Psychiatry &amp; 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