An AHRQ-commissioned cost-effectiveness analysis concluded that transcranial magnetic stimulation is cost-effective compared with continued sequential antidepressant trials for patients with treatment-resistant depression. The analysis estimated incremental cost per quality-adjusted life year (QALY) gained at approximately $42,000 — well below the commonly cited willingness-to-pay threshold of $100,000 per QALY.
Cost savings were driven primarily by averted hospitalizations and reduced use of long-term pharmacotherapy in TMS responders. Productivity gains from improved depression outcomes contributed additional value but were not the dominant driver.
The analysis used a 5-year time horizon and incorporated remission rates from real-world registry data rather than industry trial data. The authors note that cost-effectiveness improves further at 10-year horizons because of TMS's durable effects in a meaningful fraction of patients.
The findings are likely to be cited in payer policy decisions and are consistent with similar cost-effectiveness analyses from the UK, Canada, and Australia. Cost-effectiveness has historically been a barrier to broader TMS coverage in some private payer policies.
Source
Reporting based on coverage from AHRQ. This article is editorial summary intended for general information; it is not medical advice.