Cost-effectiveness and long-term effectiveness of internet-based cognitive behaviour therapy for severe health anxiety

Psychol Med. 2013 Feb;43(2):363-74. doi: 10.1017/S0033291712001079. Epub 2012 May 21.

Abstract

Background: Severe health anxiety is a common condition associated with functional disability, making it a costly disorder from a societal perspective. Internet-based cognitive behaviour therapy (ICBT) is a promising treatment but no previous study has assessed the cost-effectiveness or long-term outcome of ICBT for severe health anxiety. The aim of this study was to investigate the cost-effectiveness and 1-year treatment effects of ICBT for severe health anxiety.

Method: Cost-effectiveness and 1-year follow-up data were obtained from a randomized controlled trial (RCT) comparing ICBT (n = 40) to an attention control condition (CC, n = 41). The primary outcome measure was the Health Anxiety Inventory (HAI). A societal perspective was taken and incremental cost-effectiveness ratios (ICERs) were calculated using bootstrap sampling.

Results: The main ICER was -£1244, indicating the societal economic gain for each additional case of remission when administering ICBT. Baseline to 1-year follow-up effect sizes on the primary outcome measure were large (d = 1.71-1.95).

Conclusions: ICBT is a cost-effective treatment for severe health anxiety that can produce substantial and enduring effects.

Trial registration: ClinicalTrials.gov NCT00828152.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Anxiety / therapy
  • Attitude to Health
  • Cognitive Behavioral Therapy / economics*
  • Cost-Benefit Analysis
  • Depression / therapy
  • Female
  • Follow-Up Studies
  • Health Care Costs / statistics & numerical data*
  • Humans
  • Hypochondriasis / economics
  • Hypochondriasis / psychology
  • Hypochondriasis / therapy*
  • Internet
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care / statistics & numerical data*
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Quality-Adjusted Life Years
  • Therapy, Computer-Assisted / economics*
  • Therapy, Computer-Assisted / methods

Associated data

  • ClinicalTrials.gov/NCT00828152