Economic evaluation of online computerised cognitive-behavioural therapy without support for depression in primary care: randomised trial

Br J Psychiatry. 2010 Apr;196(4):310-8. doi: 10.1192/bjp.bp.109.065748.

Abstract

Background: Evidence about the cost-effectiveness and cost utility of computerised cognitive-behavioural therapy (CCBT) is still limited. Recently, we compared the clinical effectiveness of unsupported, online CCBT with treatment as usual (TAU) and a combination of CCBT and TAU (CCBT plus TAU) for depression. The study is registered at the Netherlands Trial Register, part of the Dutch Cochrane Centre (ISRCTN47481236).

Aims: To assess the cost-effectiveness of CCBT compared with TAU and CCBT plus TAU.

Method: Costs, depression severity and quality of life were measured for 12 months. Cost-effectiveness and cost-utility analyses were performed from a societal perspective. Uncertainty was dealt with by bootstrap replications and sensitivity analyses.

Results: Costs were lowest for the CCBT group. There are no significant group differences in effectiveness or quality of life. Cost-utility and cost-effectiveness analyses tend to be in favour of CCBT.

Conclusions: On balance, CCBT constitutes the most efficient treatment strategy, although all treatments showed low adherence rates and modest improvements in depression and quality of life.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cognitive Behavioral Therapy / economics*
  • Cognitive Behavioral Therapy / methods
  • Cost of Illness
  • Cost-Benefit Analysis
  • Depressive Disorder / economics
  • Depressive Disorder / therapy*
  • Health Care Costs / statistics & numerical data
  • Humans
  • Middle Aged
  • Netherlands
  • Primary Health Care / economics*
  • Primary Health Care / methods
  • Psychiatric Status Rating Scales
  • Quality of Life
  • Sensitivity and Specificity
  • Therapy, Computer-Assisted / economics*
  • Therapy, Computer-Assisted / methods
  • Treatment Outcome
  • Young Adult

Associated data

  • ISRCTN/ISRCTN47481236