COST-EFFECTIVENESS OF GUIDED INTERNET-BASED TREATMENTS FOR DEPRESSION IN COMPARISON WITH CONTROL CONDITIONS: AN INDIVIDUAL PARTICIPANT DATA META-ANALYSIS

Research output: Scientific - peer-reviewArticle

Abstract

Objectives: Previous studies have shown the effectiveness of guided Internetbased
interventions for depression compared to control groups. It is often hypothesized
that Internet-based treatments are associated with lower costs, because
face-to-face time with therapist is reduced. The objective of this study was to
conduct an individual-participant data meta-analysis (IPD-MA) evaluating the costeffectiveness
of guided Internet-based interventions for depression compared to
controls from a societal perspective. Methods: A systematic literature search
was conducted in electronic databases from 2000 to January 1st 2017. Studies
were included if they were randomized controlled trials (RCTs) in which the costeffectiveness
of a guided Internet-based intervention for depression was compared
to a control. Cost-effectiveness analyses were conducted for improvement in depressive
symptoms measured by CES-D, response to treatment, and Quality-Adjusted
Life-Years (QALYs) at 8-weeks, 6-months, and 12-months follow-up. Results: IPD from five studies, including 1,426 participants were used. The guided Internet-based
interventions were more costly than the controls, but not statistically significantly
so (e.g.12-months mean difference = € 406, 95%CI: -611 to 1,444). Cost-effectiveness
acceptability curves indicated that high investments are needed to reach an acceptable
probability that the intervention is cost-effective compared to control for CES-D
and response to treatment (e.g., at 12-month follow-up the probability of being costeffective
was 0.95 at a ceiling ratio of 2,000 € /point of improvement in CES-D score).
For QALYs, the intervention’s probability of being cost-effective compared to control
was low at the commonly accepted willingness-to-pay threshold (e.g., at 12-month
follow-up the probability was 0.29 and 0.31 at a ceiling ratio of 24,000 and 35,000
€ /QALY, respectively). Conclusions: Guided Internet-based interventions for
depression were not considered cost-effective compared to control. However, only
a minority of RCTs investigating the clinical effectiveness of guided Internet-based
interventions also assessed cost-effectiveness. Therefore, it is important that future
RCTs measure resource use and productivity losses alongside clinical effectiveness.
LanguageEnglish
PagesA714-A715
JournalValue in Health
Volume20
Issue number9
StatePublished - 2017

Cite this

@article{16afc26dab114fffa5e6037341b3da7e,
title = "COST-EFFECTIVENESS OF GUIDED INTERNET-BASED TREATMENTS FOR DEPRESSION IN COMPARISON WITH CONTROL CONDITIONS: AN INDIVIDUAL PARTICIPANT DATA META-ANALYSIS",
abstract = "Objectives: Previous studies have shown the effectiveness of guided Internetbasedinterventions for depression compared to control groups. It is often hypothesizedthat Internet-based treatments are associated with lower costs, becauseface-to-face time with therapist is reduced. The objective of this study was toconduct an individual-participant data meta-analysis (IPD-MA) evaluating the costeffectivenessof guided Internet-based interventions for depression compared tocontrols from a societal perspective. Methods: A systematic literature searchwas conducted in electronic databases from 2000 to January 1st 2017. Studieswere included if they were randomized controlled trials (RCTs) in which the costeffectivenessof a guided Internet-based intervention for depression was comparedto a control. Cost-effectiveness analyses were conducted for improvement in depressivesymptoms measured by CES-D, response to treatment, and Quality-AdjustedLife-Years (QALYs) at 8-weeks, 6-months, and 12-months follow-up. Results: IPD from five studies, including 1,426 participants were used. The guided Internet-basedinterventions were more costly than the controls, but not statistically significantlyso (e.g.12-months mean difference = € 406, 95%CI: -611 to 1,444). Cost-effectivenessacceptability curves indicated that high investments are needed to reach an acceptableprobability that the intervention is cost-effective compared to control for CES-Dand response to treatment (e.g., at 12-month follow-up the probability of being costeffectivewas 0.95 at a ceiling ratio of 2,000 € /point of improvement in CES-D score).For QALYs, the intervention’s probability of being cost-effective compared to controlwas low at the commonly accepted willingness-to-pay threshold (e.g., at 12-monthfollow-up the probability was 0.29 and 0.31 at a ceiling ratio of 24,000 and 35,000€ /QALY, respectively). Conclusions: Guided Internet-based interventions fordepression were not considered cost-effective compared to control. However, onlya minority of RCTs investigating the clinical effectiveness of guided Internet-basedinterventions also assessed cost-effectiveness. Therefore, it is important that futureRCTs measure resource use and productivity losses alongside clinical effectiveness.",
author = "S. Kolovos and {van Dongen}, {J. M.} and H. Riper and {van Tulder}, {M. W.} and Bosmans, {J. E.}",
year = "2017",
volume = "20",
pages = "A714--A715",
journal = "Value in Health",
issn = "1098-3015",
publisher = "Elsevier",
number = "9",

}

TY - JOUR

T1 - COST-EFFECTIVENESS OF GUIDED INTERNET-BASED TREATMENTS FOR DEPRESSION IN COMPARISON WITH CONTROL CONDITIONS: AN INDIVIDUAL PARTICIPANT DATA META-ANALYSIS

AU - Kolovos,S.

AU - van Dongen,J. M.

AU - Riper,H.

AU - van Tulder,M. W.

AU - Bosmans,J. E.

PY - 2017

Y1 - 2017

N2 - Objectives: Previous studies have shown the effectiveness of guided Internetbasedinterventions for depression compared to control groups. It is often hypothesizedthat Internet-based treatments are associated with lower costs, becauseface-to-face time with therapist is reduced. The objective of this study was toconduct an individual-participant data meta-analysis (IPD-MA) evaluating the costeffectivenessof guided Internet-based interventions for depression compared tocontrols from a societal perspective. Methods: A systematic literature searchwas conducted in electronic databases from 2000 to January 1st 2017. Studieswere included if they were randomized controlled trials (RCTs) in which the costeffectivenessof a guided Internet-based intervention for depression was comparedto a control. Cost-effectiveness analyses were conducted for improvement in depressivesymptoms measured by CES-D, response to treatment, and Quality-AdjustedLife-Years (QALYs) at 8-weeks, 6-months, and 12-months follow-up. Results: IPD from five studies, including 1,426 participants were used. The guided Internet-basedinterventions were more costly than the controls, but not statistically significantlyso (e.g.12-months mean difference = € 406, 95%CI: -611 to 1,444). Cost-effectivenessacceptability curves indicated that high investments are needed to reach an acceptableprobability that the intervention is cost-effective compared to control for CES-Dand response to treatment (e.g., at 12-month follow-up the probability of being costeffectivewas 0.95 at a ceiling ratio of 2,000 € /point of improvement in CES-D score).For QALYs, the intervention’s probability of being cost-effective compared to controlwas low at the commonly accepted willingness-to-pay threshold (e.g., at 12-monthfollow-up the probability was 0.29 and 0.31 at a ceiling ratio of 24,000 and 35,000€ /QALY, respectively). Conclusions: Guided Internet-based interventions fordepression were not considered cost-effective compared to control. However, onlya minority of RCTs investigating the clinical effectiveness of guided Internet-basedinterventions also assessed cost-effectiveness. Therefore, it is important that futureRCTs measure resource use and productivity losses alongside clinical effectiveness.

AB - Objectives: Previous studies have shown the effectiveness of guided Internetbasedinterventions for depression compared to control groups. It is often hypothesizedthat Internet-based treatments are associated with lower costs, becauseface-to-face time with therapist is reduced. The objective of this study was toconduct an individual-participant data meta-analysis (IPD-MA) evaluating the costeffectivenessof guided Internet-based interventions for depression compared tocontrols from a societal perspective. Methods: A systematic literature searchwas conducted in electronic databases from 2000 to January 1st 2017. Studieswere included if they were randomized controlled trials (RCTs) in which the costeffectivenessof a guided Internet-based intervention for depression was comparedto a control. Cost-effectiveness analyses were conducted for improvement in depressivesymptoms measured by CES-D, response to treatment, and Quality-AdjustedLife-Years (QALYs) at 8-weeks, 6-months, and 12-months follow-up. Results: IPD from five studies, including 1,426 participants were used. The guided Internet-basedinterventions were more costly than the controls, but not statistically significantlyso (e.g.12-months mean difference = € 406, 95%CI: -611 to 1,444). Cost-effectivenessacceptability curves indicated that high investments are needed to reach an acceptableprobability that the intervention is cost-effective compared to control for CES-Dand response to treatment (e.g., at 12-month follow-up the probability of being costeffectivewas 0.95 at a ceiling ratio of 2,000 € /point of improvement in CES-D score).For QALYs, the intervention’s probability of being cost-effective compared to controlwas low at the commonly accepted willingness-to-pay threshold (e.g., at 12-monthfollow-up the probability was 0.29 and 0.31 at a ceiling ratio of 24,000 and 35,000€ /QALY, respectively). Conclusions: Guided Internet-based interventions fordepression were not considered cost-effective compared to control. However, onlya minority of RCTs investigating the clinical effectiveness of guided Internet-basedinterventions also assessed cost-effectiveness. Therefore, it is important that futureRCTs measure resource use and productivity losses alongside clinical effectiveness.

UR - https://doi.org/10.1016/j.jval.2017.08.1898

M3 - Article

VL - 20

SP - A714-A715

JO - Value in Health

T2 - Value in Health

JF - Value in Health

SN - 1098-3015

IS - 9

ER -