BACKGROUND: Evidence about the cost-effectiveness and cost utility of computerised cognitive-behavioural therapy (CCBT) is still limited. Recently, we compared the clinical effectiveness of unsupported, online CCBT with treatment as usual (TAU) and a combination of CCBT and TAU (CCBT plus TAU) for depression. The study is registered at the Netherlands Trial Register, part of the Dutch Cochrane Centre (ISRCTN47481236). AIMS: To assess the cost-effectiveness of CCBT compared with TAU and CCBT plus TAU. METHOD: Costs, depression severity and quality of life were measured for 12 months. Cost-effectiveness and cost-utility analyses were performed from a societal perspective. Uncertainty was dealt with by bootstrap replications and sensitivity analyses. RESULTS: Costs were lowest for the CCBT group. There are no significant group differences in effectiveness or quality of life. Cost-utility and cost-effectiveness analyses tend to be in favour of CCBT. CONCLUSIONS: On balance, CCBT constitutes the most efficient treatment strategy, although all treatments showed low adherence rates and modest improvements in depression and quality of life.

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Keywords Adolescent, Adult, Aged, Cognitive Therapy/*economics/methods, Cost of Illness, Cost-Benefit Analysis, Depressive Disorder/economics/*therapy, Health Care Costs/statistics & numerical data, Humans, Middle Aged, Netherlands, Primary Health Care/*economics/methods, Psychiatric Status Rating Scales, Quality of Life, Sensitivity and Specificity, Therapy, Computer-Assisted/*economics/methods, Treatment Outcome, Young Adult
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Journal British Journal of Psychiatry
Gerhards, S.A.H, de Graaf, L.E, Jacobs, L.E, Severens, J.L, Huibers, M.J.H, Arntz, A, … Evers, S.M.A.A. (2010). Economic evaluation of online computerised cognitive-behavioural therapy without support for depression in primary care: randomised trial. British Journal of Psychiatry, 196(4), 310–318. doi:10.1192/bjp.bp.109.065748