A health economic outcome evaluation of an internet-based mobile-supported stress management intervention for employees

David Daniel Ebert*, Fanny Kählke, Claudia Buntrock, Matthias Berking, Filip Smit, Elena Heber, Harald Baumeister, Burkhardt Funk, Heleen Riper, Dirk Lehr

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


Objective This study aimed to estimate and evaluate the cost-effectiveness and cost-benefit of a guided internet-and mobile-supported occupational stress-management intervention (iSMI) for employees from the employer’s perspective alongside a randomized controlled trial. Methods A sample of 264 employees with elevated symptoms of perceived stress (Perceived Stress Scale, PSS-10 ≥22) was randomly assigned either to the iSMI or a waitlist control (WLC) group with unrestricted access to treatment as usual. The iSMI consisted of seven sessions of problem-solving and emotion-regulation techniques and one booster session. Self-report data on symptoms of perceived stress and economic data were assessed at baseline, and at six months following randomization. A cost-benefit analysis (CBA) and a cost-effectiveness analysis (CEA) with symptom-free status as the main outcome from the employer’s perspective was carried out. Statistical uncertainty was estimated using bootstrapping (N=5000). Results The CBA yielded a net-benefit of €181 [95% confidence interval (CI) -6043–1042] per participant within the first six months following randomization. CEA showed that at a willingness-to-pay ceiling of €0, €1000, €2000 for one additional symptom free employee yielded a 67%, 90%, and 98% probability, respectively, of the intervention being cost-effective compared to the WLC. Conclusion The iSMI was cost-effective when compared to WLC and even lead to cost savings within the first six months after randomization. Offering stress-management interventions can present good value for money in occupational healthcare.

Original languageEnglish
Pages (from-to)171-182
Number of pages12
JournalScandinavian Journal of Work, Environment and Health
Issue number2
Publication statusPublished - Apr 2018


  • CBT
  • Cost-benefit analysis
  • Cost-effectiveness analysis
  • E-health
  • Economic evaluation
  • Internet-based intervention
  • M-health
  • Randomized controlled trial
  • RCT


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