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Cost Utility Analysis of Internet-Based Cognitive Behavioral Therapy for Major Depressive Disorder: Randomized
Wenjing Zhou1,2, Yan Chen3, Herui Wu1,2
1Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Journal of Medical Internet Research
|February 19, 2025
Summary
Unguided internet-based cognitive behavioral therapy (ICBT) is a cost-effective treatment for major depressive disorder (MDD), improving patient outcomes and generating societal savings in low-resource settings. This scalable intervention offers significant health economic benefits.
Area of Science:
- Mental Health Research
- Health Economics
- Digital Therapeutics
Background:
- Major depressive disorder (MDD) is a significant global health burden.
- Internet-based cognitive behavioral therapy (ICBT) shows promise for MDD treatment.
- Cost-effectiveness of unguided ICBT in low-resource settings remains understudied.
Purpose of the Study:
- To evaluate the short- and long-term cost utility of unguided ICBT versus a waitlist control for MDD.
- To assess cost-effectiveness from societal and healthcare system perspectives.
- To provide health economic evidence for scalable MDD interventions.
Main Methods:
- An 8-week randomized controlled trial with a 12-month follow-up in Shenzhen, China.
- Collected data on direct medical costs, indirect costs, and health utility (Short-Form Six-Dimension).
- Calculated incremental cost utility ratios (ICURs) and used cost-effectiveness planes/curves.
Main Results:
- 244 participants with MDD were randomized to ICBT or waitlist control.
- ICBT group showed better quality of life and cost-effectiveness from societal and healthcare perspectives.
- Adjusted ICURs indicated significant cost-effectiveness, with probabilities of 75.93% and 54.4% respectively.
Conclusions:
- Unguided ICBT is a cost-effective treatment for MDD.
- The intervention leads to clinical improvement and societal economic benefits.
- Findings support ICBT as a scalable MDD treatment for low- and middle-income countries.
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