Cost-effectiveness of computerised cognitive-behavioural therapy for anxiety and depression in primary care: randomised controlled trial

Br J Psychiatry. 2004 Jul:185:55-62. doi: 10.1192/bjp.185.1.55.

Abstract

Background: Cognitive-behavioural therapy (CBT) is effective for treating anxiety and depression in primary care, but there is a shortage of therapists. Computer-delivered treatment may be a viable alternative.

Aims: To assess the cost-effectiveness of computer-delivered CBT.

Method: A sample of people with depression or anxiety were randomised to usual care (n=128) or computer-delivered CBT (n=146). Costs were available for 123 and 138 participants, respectively. Costs and depression scores were combined using the net benefit approach.

Results: Service costs were 40 British pounds (90% CI - 28 British pounds to 148 British pounds) higher over 8 months for computer-delivered CBT. Lost-employment costs were 407 British pounds (90% CI 196 British pounds to 586 British pounds) less for this group. Valuing a 1-unit improvement on the Beck Depression Inventory at 40 British pounds, there is an 81% chance that computer-delivered CBT is cost-effective, and it revealed a highly competitive cost per quality-adjusted life year.

Conclusions: Computer-delivered CBT has a high probability of being cost-effective, even if a modest value is placed on unit improvements in depression.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Anxiety / economics
  • Anxiety / therapy*
  • Anxiety Disorders / economics
  • Anxiety Disorders / therapy
  • Cognitive Behavioral Therapy / economics*
  • Cognitive Behavioral Therapy / methods
  • Computer-Assisted Instruction / economics*
  • Cost of Illness
  • Cost-Benefit Analysis
  • Depression / economics
  • Depression / therapy*
  • Female
  • Health Care Costs
  • Humans
  • Male
  • Middle Aged
  • Primary Health Care / economics*
  • Primary Health Care / methods
  • Treatment Outcome