title: Economic evaluation of online computerised cognitive-behavioural therapy without support for depression in primary care: randomised trial.
abstract: 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).
  
  
  OBJECTIVE
  To assess the cost-effectiveness of CCBT compared with TAU and CCBT plus TAU.
  
  
  METHODS
  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.
authors.affiliation: Department of Clinical Psychological Science, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands. S.Gerhards@maastrichtuniversity.nl
authors.forename: S A H
authors.initials: SA
authors.lastname: Gerhards
authors.forename: L E
authors.initials: LE
authors.lastname: de Graaf
authors.forename: L E
authors.initials: LE
authors.lastname: Jacobs
authors.forename: J L
authors.initials: JL
authors.lastname: Severens
authors.forename: M J H
authors.initials: MJ
authors.lastname: Huibers
authors.forename: A
authors.initials: A
authors.lastname: Arntz
authors.forename: H
authors.initials: H
authors.lastname: Riper
authors.forename: G
authors.initials: G
authors.lastname: Widdershoven
authors.forename: J F M
authors.initials: JF
authors.lastname: Metsemakers
authors.forename: S M A A
authors.initials: SM
authors.lastname: Evers
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000191:economics* / Q000379:methods; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003866:Depressive Disorder / Q000191:economics / Q000628:therapy*; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D009426:Netherlands; D011320:Primary Health Care / Q000191:economics* / Q000379:methods; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012680:Sensitivity and Specificity; D013813:Therapy, Computer-Assisted / Q000191:economics* / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult