Background: Repetitive transcranial magnetic stimulation (rTMS) is a new treatment with promise for resistant depression.
Objective: We tested the economic feasibility of this new method compared with electroconvulsive therapy (ECT).
Method: An economic decision analysis was used to compare the costs of three different treatment strategies for nonpsychotic severe depression. The strategies were: ECT alone; rTMS alone; and rTMS followed by ECT for nonresponders (rTMS-to-ECT). We calculated 12-month costs and quality adjusted life years (QALYs) for the three treatment options for all nonpsychotic, severely depressed United States patients who would have otherwise undergone ECT. A sensitivity analysis was performed to test the degree of change in outcome with various parameter changes.