Cost-effectiveness of therapist-delivered online cognitive-behavioural therapy for depression: randomised controlled trial

Abstract

Background: Therapist-delivered online cognitive-behavioural therapy (CBT) has been found to be effective for depression in primary care.

Aims: To determine the cost-effectiveness of online CBT compared with usual care.

Method: Economic evaluation at 8 months alongside a randomised controlled trial. Cost to the National Health Service (NHS), personal costs, and the value of lost productivity, each compared with outcomes based on the Beck Depression Inventory and quality-adjusted life-years (QALYs). Incremental analysis indicated the NHS cost per QALY gain.

Results: Online CBT was more expensive than usual care, although the outcomes for the CBT group were better. Cost per QALY gain based on complete case data was £17,173, and £10,083 when missing data were imputed.

Conclusions: Online CBT delivered by a therapist in real time is likely to be cost-effective compared with usual care if society is willing to pay at least £20,000 per QALY; it could be a useful alternative to face-to-face CBT.