Cost effectiveness of guided Internet-based interventions for depression in comparison with control conditions: An individual–participant data meta-analysis

Research output: Journal contributionsScientific review articlesResearch

Authors

  • Spyros Kolovos
  • Johanna M. van Dongen
  • Heleen Riper
  • Claudia Buntrock
  • Pim Cuijpers
  • David D. Ebert
  • Anna S. Geraedts
  • Robin M. Kenter
  • Stephanie Nobis
  • Andrea Smith
  • Lisanne Warmerdam
  • Jill A. Hayden
  • Maurits W. van Tulder
  • Judith E. Bosmans

Background: There is limited evidence on the cost effectiveness of Internet-based treatments for depression. The aim was to evaluate the cost effectiveness of guided Internet-based interventions for depression compared to controls. Methods: Individual–participant data from five randomized controlled trials (RCT), including 1,426 participants, were combined. Cost-effectiveness analyses were conducted at 8 weeks, 6 months, and 12 months follow-up. Results: The guided Internet-based interventions were more costly than the controls, but not statistically significant (12 months mean difference = €406, 95% CI: − 611 to 1,444). The mean differences in clinical effects were not statistically significant (12 months mean difference = 1.75, 95% CI: −.09 to 3.60 in Center for Epidemiologic Studies Depression Scale [CES-D] score,.06, 95% CI: −.02 to.13 in response rate, and.00, 95% CI: −.03 to.03 in quality-adjusted life-years [QALYs]). Cost-effectiveness acceptability curves indicated that high investments are needed to reach an acceptable probability that the intervention is cost effective compared to control for CES-D and response to treatment (e.g., at 12-month follow-up the probability of being cost effective was.95 at a ceiling ratio of 2,000 €/point of improvement in CES-D score). For QALYs, the intervention's probability of being cost effective compared to control was low at the commonly accepted willingness-to-pay threshold (e.g., at 12-month follow-up the probability was.29 and. 31 at a ceiling ratio of 24,000 and 35,000 €/QALY, respectively). Conclusions: Based on the present findings, guided Internet-based interventions for depression are not considered cost effective compared to controls. However, only a minority of RCTs investigating the clinical effectiveness of guided Internet-based interventions also assessed cost effectiveness and were included in this individual–participant data meta-analysis.

Original languageEnglish
JournalDepression and Anxiety
Volume35
Issue number3
Pages (from-to)209-219
Number of pages11
ISSN1091-4269
DOIs
Publication statusPublished - 03.2018

Bibliographical note

Publisher Copyright:
© 2018, The Authors. Depression and Anxiety published by Wiley Periodicals, Inc.

    Research areas

  • cost effectiveness, cost utility, depression, individual–participant data meta-analysis, Internet-based intervention
  • Health sciences
  • Psychology

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