Cost-effectiveness of computerised cognitive-behavioural therapy for anxiety and depression in primary care: Randomised controlled trial

  • McCrone P
  • Knapp M
  • Proudfoot J
 et al. 
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Abstract

Background Cognitive-behavioural therapy (CBT) is effective for treating anxiety and depression in primary care, but there is a shortage of therapists. Computer-delivered treatment may be a viable alternative. Aims To assess the cost-effectiveness of computer-delivered CBT. Method A sample of people with depression or anxiety were randomised to usual care (n=128) or computer-delivered CBT (n=146). Costs were available for 123 and 138 participants, respectively. Costs and depression scores were combined using the net benefit approach. Results Service costs were {pound}40 (90% CI - {pound}28 to {pound}148) higher over 8 months for computer-delivered CBT. Lost-employment costs were {pound}407 (90% CI {pound}196 to {pound}586) less for this group. Valuing a 1-unit improvement on the Beck Depression Inventory at {pound}40, there is an 81% chance that computer-delivered CBT is cost-effective, and it revealed a highly competitive cost per quality-adjusted life year. Conclusions Computer-delivered CBT has a high probability of being cost-effective, even if a modest value is placed on unit improvements in depression.

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Authors

  • P. McCrone

  • M. Knapp

  • J. Proudfoot

  • C. Ryden

  • K. Cavanagh

  • D. Shapiro

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