Effectiveness, patient matching, and insurance coverage for depression.

The effectiveness of treatment for depression is not in doubt, and common humanity would indicate that it should be provided to those that need it. However, in this paper I argue that the existence of effective treatment should not be regarded as a sufficient condition for the extension of insurance cover. This is because insurance coverage cannot guarantee that treatment is delivered effectively, nor that it is given to the right people; neither does it lend itself to the maximization of cost-effectiveness. Payment systems must take account of these considerations.