Automated Feedback After Internet-Based Depression Screening: Cost-Effectiveness Analysis of a Randomized Controlled...

Area of Science:

• Health Economics
• Digital Health Interventions
• Mental Health Services Research

Background:

• Clinical and cost consequences of internet-based depression screening with automated feedback are under-researched.
• The DISCOVER trial evaluated two automated feedback versions after online depression screening.

Purpose of the Study:

• To assess the cost-effectiveness of automated nontailored and tailored feedback interventions following internet-based depression screening.
• Analysis was conducted from a societal perspective.

Main Methods:

• 1012 participants screened positive for depression were randomized to no feedback, nontailored feedback, or tailored feedback.
• Interventions included screening results, advice, and depression information; tailored feedback was personalized.
• Cost-effectiveness was measured using quality-adjusted life years (QALYs) over 6 months.

Main Results:

• No statistically significant differences in costs or QALYs were observed between groups.
• Both no feedback and tailored feedback dominated nontailored feedback.
• Tailored feedback had an incremental cost-effectiveness ratio (ICER) of €109,730 per QALY compared to no feedback, with lower costs and QALYs.

Conclusions:

• Automated feedback interventions did not significantly impact societal costs or QALYs at 6 months.
• Tailored feedback showed moderate cost-effectiveness probabilities against no feedback.
• Subgroup analyses identified potential cost-effectiveness in specific populations.