title: Cost-effectiveness of therapist-delivered online cognitive-behavioural therapy for depression: randomised controlled trial.
abstract: BACKGROUND
  Therapist-delivered online cognitive-behavioural therapy (CBT) has been found to be effective for depression in primary care.
  
  
  OBJECTIVE
  To determine the cost-effectiveness of online CBT compared with usual care.
  
  
  METHODS
  Economic evaluation at 8 months alongside a randomised controlled trial. Cost to the National Health Service (NHS), personal costs, and the value of lost productivity, each compared with outcomes based on the Beck Depression Inventory and quality-adjusted life-years (QALYs). Incremental analysis indicated the NHS cost per QALY gain.
  
  
  RESULTS
  Online CBT was more expensive than usual care, although the outcomes for the CBT group were better. Cost per QALY gain based on complete case data was £17,173, and £10,083 when missing data were imputed.
  
  
  CONCLUSIONS
  Online CBT delivered by a therapist in real time is likely to be cost-effective compared with usual care if society is willing to pay at least £20,000 per QALY; it could be a useful alternative to face-to-face CBT.
authors.affiliation: Academic Unit of Primary Health Care, Department of Community Based Medicine, University of Bristol, UK. s.p.hollinghurst@bristol.ac.uk
authors.forename: Sandra
authors.initials: S
authors.lastname: Hollinghurst
authors.forename: Tim J
authors.initials: TJ
authors.lastname: Peters
authors.forename: Surinder
authors.initials: S
authors.lastname: Kaur
authors.forename: Nicola
authors.initials: N
authors.lastname: Wiles
authors.forename: Glyn
authors.initials: G
authors.lastname: Lewis
authors.forename: David
authors.initials: D
authors.lastname: Kessler
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; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D008499:Medical Records; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011569:Psychiatric Status Rating Scales; D019057:Quality-Adjusted Life Years; D018582:Sick Leave; D013222:State Medicine / Q000191:economics; D013813:Therapy, Computer-Assisted / Q000191:economics*; D055815:Young Adult