Depression Management at the Workplace

Randomized trials demonstrate that depression management products can improve clinical and
organizational outcomes sufficiently for selected employers to realize a return on
investment. Rather than usual care marketing which uses voltage-enhanced promises to sell
voltage-diminished products, the investigators designed an evidence-based (EB) intervention
to encourage employers to purchase a depression management product that offers the type,
intensity and duration of care shown to provide clinical and organizational value. In an
RCT designed to examine employer benefit purchasing behavior of depression products in 360
employer members of over 20 regional business coalitions, the research team proposes: (a) to
compare the impact of evidence-based (EB) to usual care (UC) presentations on employer
benefit purchasing behavior, and (b) to identify mediators and organizational moderators of
intervention impact on employer benefit purchasing behavior.

This study addresses what policy analysts argue is one of the most pivotal problems in the
translation of evidence-based care to 'real world' settings: whether purchasers can be
influenced to buy health care products on the basis of value rather than cost. In the
likely event that EB > UC, the study will provide encouragement to use an evidence-based
approach to market new health care products to private payers on the basis of the product's
clinical and organizational value. UC may achieve comparable outcomes to EB if the limiting
factors in benefit purchasing are organizational, purchasing group and vendor constraints
that no intervention can meaningfully modify. Support for this scenario would encourage
the targeted marketing of new products to coalition members with empirically identified
organizational, purchasing group and vendor characteristics, using usual care strategies.