title: Cost-utility and cost-effectiveness of internet-based treatment for adults with depressive symptoms: randomized trial.
abstract: BACKGROUND
  The effectiveness of Internet-based treatments for depression has been demonstrated; their cost-effectiveness, however, has been less well researched.
  
  
  OBJECTIVE
  Evaluating the relative cost-utility and cost-effectiveness of (1) Internet-based cognitive behavioral therapy, (2) Internet-based problem-solving therapy, and (3) a waiting list for adults with depressive symptoms.
  
  
  METHODS
  A total of 263 participants with clinically significant depressive symptoms were randomized to Internet-based cognitive behavioral therapy (n = 88), Internet-based problem-solving therapy (n = 88), and a waiting list (n = 87). End points were evaluated at the 12-week follow-up.
  
  
  RESULTS
  Cost-utility analysis showed that cognitive behavioral therapy and problem-solving therapy had a 52% and 61% probability respectively of being more acceptable than waiting when the willingness to pay is € 30,000 for one quality-adjusted life-year. When society is prepared to pay € 10,000 for a clinically significant change from depression, the probabilities of cognitive behavioral therapy and problem-solving therapy being more acceptable than waiting are 91% and 89%, respectively. Comparing both Internet-based treatments showed no clear preference for one or the other of the treatments.
  
  
  CONCLUSIONS
  Both Internet-based treatments have a high probability of being cost-effective with a modest value placed on clinically significant change in depressive symptoms.
  
  
  BACKGROUND
  ISRCTN16823487; http://www.controlled-trials.com/ISRCTN16823487 (Archived by WebCite at http://www.webcitation.org/5u8slzhDE).
authors.affiliation: Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, Netherlands. eh.warmerdam@psy.vu.nl
authors.forename: Lisanne
authors.initials: L
authors.lastname: Warmerdam
authors.forename: Filip
authors.initials: F
authors.lastname: Smit
authors.forename: Annemieke
authors.initials: A
authors.lastname: van Straten
authors.forename: Heleen
authors.initials: H
authors.lastname: Riper
authors.forename: Pim
authors.initials: P
authors.lastname: Cuijpers
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000191:economics* / Q000379:methods; D003362:Cost-Benefit Analysis; D003863:Depression / Q000191:economics* / Q000534:rehabilitation; D003866:Depressive Disorder / Q000191:economics* / Q000534:rehabilitation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011340:Problem Solving; D012648:Self Care / Q000191:economics; D013813:Therapy, Computer-Assisted / Q000191:economics* / Q000379:methods; D016896:Treatment Outcome; D014850:Waiting Lists; D055815:Young Adult