Repetitive transcranial magnetic stimulation for treatment resistant depression

Objectives This analysis evaluates the cost-effectiveness of rTMS for patients with TRD compared with ECT or sham rTMS and estimates the potential budgetary impact of various levels of implementation of rTMS in Ontario. [...] The results of the economic analyses are presented for rTMS alone versus electroconvulsive therapy (ECT) alone and for rTMS alone compared with sham rTMS, and the budget impact of implementing rTMS is estimated. [...] These analyses are then presented to the Ontario Health Technology Advisory Committee, whose mandate it is to examine proposed health technologies in the context of available evidence and existing clinical practice, and to provide advice and recommendations to Ontario health care practitioners, the broader health care system, and the Ontario Ministry of Health and Long-Term Care. [...] Objective of Analysis This analysis aimed to evaluate the cost-effectiveness of rTMS for persons with treatment- resistant depression (TRD) compared with ECT or sham rTMS, as well as to estimate the potential budgetary impact of various levels of implementation of rTMS in Ontario from the perspective of the Ontario Ministry of Health and Long-Term Care. [...] The percentage of Ontarians reporting an episode in the last year ranges from 9% in female patients aged 15 to 24 years to 1.4% in male patients aged 65 years and older.5 Given the lack of consensus on the definition of TRD, disagreement on the prevalence is unsurprising.