Internet-Based Cognitive Behavioral Therapy for Insomnia: A Health Economic Evaluation

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Internet-Based Cognitive Behavioral Therapy for Insomnia : A Health Economic Evaluation. / Thiart, Hanne; Ebert, David Daniel; Lehr, Dirk et al.

In: Sleep, Vol. 39, No. 10, 01.10.2016, p. 1769-1778.

Research output: Journal contributionsJournal articlesResearchpeer-review

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Thiart H, Ebert DD, Lehr D, Nobis S, Buntrock C, Berking M et al. Internet-Based Cognitive Behavioral Therapy for Insomnia: A Health Economic Evaluation. Sleep. 2016 Oct 1;39(10):1769-1778. doi: 10.5665/sleep.6152

Bibtex

@article{a8b43f03fe664e58bbf2a762edc34f39,
title = "Internet-Based Cognitive Behavioral Therapy for Insomnia: A Health Economic Evaluation",
abstract = "Study Objectives: Lost productivity caused by insomnia is a common and costly problem for employers. Although evidence for the efficacy of Internet-based cognitive behavioral therapy for insomnia (iCBT-I) already exists, little is known about its economic effects. This study aims to evaluate the cost-effectiveness and cost-benefit of providing iCBT-I to symptomatic employees from the employer's perspective. Methods: School teachers (N = 128) with clinically significant insomnia symptoms and work-related rumination were randomized to guided iCBT-I or a waitlist-control-group, both with access to treatment as usual. Economic data were collected at baseline and 6-mo follow-up. We conducted (1) a costeffectiveness analysis with treatment response (Reliable Change [decline of 5.01 points] and Insomnia Severity Index < 8 at 6-month follow-up) as the outcome and (2) a cost-benefit analysis. Because both analyses were performed from the employer's perspective, we focused specifically on absenteeism and presenteeism costs. Statistical uncertainty was estimated using bootstrapping. Results: Assuming intervention costs of €200 ($245), cost-effectiveness analyses showed that at a willingness-to-pay of €0 for each positive treatment response, there is an 87% probability that the intervention is more cost effective than treatment as usual alone. Cost-benefit analyses led to a net benefit of €418 (95% confidence interval: -593.03 to 1,488.70) ($512) per participant and a return on investment of 208% (95% confidence interval: -296.52 to 744.35). The reduction in costs was mainly driven by the effects of the intervention on presenteeism and to a lesser degree by reduced absenteeism. Conclusions: Focusing on sleep improvement using iCBT-I may be a cost-effective strategy in occupational health care.",
keywords = "Psychology, cost-benefit, cost-effectiveness, employer perspective, insomnia, randomized controlled trial, self-help, Internet, Business psychology, Digital media",
author = "Hanne Thiart and Ebert, {David Daniel} and Dirk Lehr and Stephanie Nobis and Claudia Buntrock and Matthias Berking and Filip Smit and Heleen Riper",
year = "2016",
month = oct,
day = "1",
doi = "10.5665/sleep.6152",
language = "English",
volume = "39",
pages = "1769--1778",
journal = "Sleep",
issn = "0161-8105",
publisher = "American Academy of Sleep Medicine",
number = "10",

}

RIS

TY - JOUR

T1 - Internet-Based Cognitive Behavioral Therapy for Insomnia

T2 - A Health Economic Evaluation

AU - Thiart, Hanne

AU - Ebert, David Daniel

AU - Lehr, Dirk

AU - Nobis, Stephanie

AU - Buntrock, Claudia

AU - Berking, Matthias

AU - Smit, Filip

AU - Riper, Heleen

PY - 2016/10/1

Y1 - 2016/10/1

N2 - Study Objectives: Lost productivity caused by insomnia is a common and costly problem for employers. Although evidence for the efficacy of Internet-based cognitive behavioral therapy for insomnia (iCBT-I) already exists, little is known about its economic effects. This study aims to evaluate the cost-effectiveness and cost-benefit of providing iCBT-I to symptomatic employees from the employer's perspective. Methods: School teachers (N = 128) with clinically significant insomnia symptoms and work-related rumination were randomized to guided iCBT-I or a waitlist-control-group, both with access to treatment as usual. Economic data were collected at baseline and 6-mo follow-up. We conducted (1) a costeffectiveness analysis with treatment response (Reliable Change [decline of 5.01 points] and Insomnia Severity Index < 8 at 6-month follow-up) as the outcome and (2) a cost-benefit analysis. Because both analyses were performed from the employer's perspective, we focused specifically on absenteeism and presenteeism costs. Statistical uncertainty was estimated using bootstrapping. Results: Assuming intervention costs of €200 ($245), cost-effectiveness analyses showed that at a willingness-to-pay of €0 for each positive treatment response, there is an 87% probability that the intervention is more cost effective than treatment as usual alone. Cost-benefit analyses led to a net benefit of €418 (95% confidence interval: -593.03 to 1,488.70) ($512) per participant and a return on investment of 208% (95% confidence interval: -296.52 to 744.35). The reduction in costs was mainly driven by the effects of the intervention on presenteeism and to a lesser degree by reduced absenteeism. Conclusions: Focusing on sleep improvement using iCBT-I may be a cost-effective strategy in occupational health care.

AB - Study Objectives: Lost productivity caused by insomnia is a common and costly problem for employers. Although evidence for the efficacy of Internet-based cognitive behavioral therapy for insomnia (iCBT-I) already exists, little is known about its economic effects. This study aims to evaluate the cost-effectiveness and cost-benefit of providing iCBT-I to symptomatic employees from the employer's perspective. Methods: School teachers (N = 128) with clinically significant insomnia symptoms and work-related rumination were randomized to guided iCBT-I or a waitlist-control-group, both with access to treatment as usual. Economic data were collected at baseline and 6-mo follow-up. We conducted (1) a costeffectiveness analysis with treatment response (Reliable Change [decline of 5.01 points] and Insomnia Severity Index < 8 at 6-month follow-up) as the outcome and (2) a cost-benefit analysis. Because both analyses were performed from the employer's perspective, we focused specifically on absenteeism and presenteeism costs. Statistical uncertainty was estimated using bootstrapping. Results: Assuming intervention costs of €200 ($245), cost-effectiveness analyses showed that at a willingness-to-pay of €0 for each positive treatment response, there is an 87% probability that the intervention is more cost effective than treatment as usual alone. Cost-benefit analyses led to a net benefit of €418 (95% confidence interval: -593.03 to 1,488.70) ($512) per participant and a return on investment of 208% (95% confidence interval: -296.52 to 744.35). The reduction in costs was mainly driven by the effects of the intervention on presenteeism and to a lesser degree by reduced absenteeism. Conclusions: Focusing on sleep improvement using iCBT-I may be a cost-effective strategy in occupational health care.

KW - Psychology

KW - cost-benefit

KW - cost-effectiveness

KW - employer perspective

KW - insomnia

KW - randomized controlled trial

KW - self-help

KW - Internet

KW - Business psychology

KW - Digital media

UR - http://www.scopus.com/inward/record.url?scp=84992390436&partnerID=8YFLogxK

U2 - 10.5665/sleep.6152

DO - 10.5665/sleep.6152

M3 - Journal articles

C2 - 27450686

VL - 39

SP - 1769

EP - 1778

JO - Sleep

JF - Sleep

SN - 0161-8105

IS - 10

ER -

DOI