Sarah Paganini1, Wiebke Teigelkötter2, Claudia Buntrock3, Harald Baumeister4. 1. Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Germany. Electronic address: sarah.paganini@psychologie.uni-freiburg.de. 2. Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Germany. 3. Department of Clinical Psychology and Psychotherapy, University of Erlangen-Nuremberg, Germany. 4. Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Germany.
Abstract
BACKGROUND: Internet- and mobile-based interventions (IMIs) targeting depression have been shown to be clinically effective and are considered a cost-effective complement to established interventions. The aim of this review was to provide an overview of the evidence for the cost-effectiveness of IMIs for the treatment and prevention of depression. METHODS: A systematic database search was conducted (Medline, PsychInfo, CENTRAL, PSYNDEX, OHE HEED). Relevant articles were selected according to defined eligibility criteria. IMIs were classified as cost-effective if they were below a willingness-to-pay threshold (WTP) of €22,845 (£20,000) - €34,267 (£30,000) per additional quality-adjusted life year (QALY) according to the National Institute for Health and Clinical Excellence (NICE) standard. Study quality was assessed using the Consolidated Health Economic Evaluation Reporting Standard guidelines and the Cochrane Risk of Bias Tool. RESULTS: Of 1538 studies, seven economic evaluations of IMIs for the treatment of major depression, four for the treatment of subthreshold/minor depression and one for the prevention of depression. In six studies, IMIs were classified as likely to be cost-effective with an incremental cost-utility ratio between €3088 and €22,609. All of these IMIs were guided. Overall quality of most economic evaluations was evaluated as good. All studies showed some risk of bias. LIMITATIONS: The studies used different methodologies and showed some risk of bias. These aspects as well as the classification of cost-effectiveness according to the WTP proposed by NICE should be considered when interpreting the results. CONCLUSIONS: Results indicate that guided IMIs for the treatment of (subthreshold) depression have the potential to be a cost-effective complement to established interventions, but more methodologically sound studies are needed.
BACKGROUND: Internet- and mobile-based interventions (IMIs) targeting depression have been shown to be clinically effective and are considered a cost-effective complement to established interventions. The aim of this review was to provide an overview of the evidence for the cost-effectiveness of IMIs for the treatment and prevention of depression. METHODS: A systematic database search was conducted (Medline, PsychInfo, CENTRAL, PSYNDEX, OHE HEED). Relevant articles were selected according to defined eligibility criteria. IMIs were classified as cost-effective if they were below a willingness-to-pay threshold (WTP) of €22,845 (£20,000) - €34,267 (£30,000) per additional quality-adjusted life year (QALY) according to the National Institute for Health and Clinical Excellence (NICE) standard. Study quality was assessed using the Consolidated Health Economic Evaluation Reporting Standard guidelines and the Cochrane Risk of Bias Tool. RESULTS: Of 1538 studies, seven economic evaluations of IMIs for the treatment of major depression, four for the treatment of subthreshold/minor depression and one for the prevention of depression. In six studies, IMIs were classified as likely to be cost-effective with an incremental cost-utility ratio between €3088 and €22,609. All of these IMIs were guided. Overall quality of most economic evaluations was evaluated as good. All studies showed some risk of bias. LIMITATIONS: The studies used different methodologies and showed some risk of bias. These aspects as well as the classification of cost-effectiveness according to the WTP proposed by NICE should be considered when interpreting the results. CONCLUSIONS: Results indicate that guided IMIs for the treatment of (subthreshold) depression have the potential to be a cost-effective complement to established interventions, but more methodologically sound studies are needed.
Authors: Lasse B Sander; Sarah Paganini; Yannik Terhorst; Sandra Schlicker; Jiaxi Lin; Kerstin Spanhel; Claudia Buntrock; David D Ebert; Harald Baumeister Journal: JAMA Psychiatry Date: 2020-10-01 Impact factor: 21.596
Authors: Eileen Bendig; Natalie Bauereiß; David Daniel Ebert; Frank Snoek; Gerhard Andersson; Harald Baumeister Journal: Dtsch Arztebl Int Date: 2018-11-05 Impact factor: 5.594
Authors: Lina Gega; Dina Jankovic; Pedro Saramago; David Marshall; Sarah Dawson; Sally Brabyn; Georgios F Nikolaidis; Hollie Melton; Rachel Churchill; Laura Bojke Journal: Health Technol Assess Date: 2022-01 Impact factor: 4.014
Authors: David C Mohr; Francisca Azocar; Andrew Bertagnolli; Tanzeem Choudhury; Paul Chrisp; Richard Frank; Henry Harbin; Trina Histon; Debra Kaysen; Camille Nebeker; Derek Richards; Stephen M Schueller; Nickolai Titov; John Torous; Patricia A Areán Journal: Psychiatr Serv Date: 2021-01-20 Impact factor: 4.157