title: Cost-effectiveness and long-term effectiveness of internet-based cognitive behaviour therapy for severe health anxiety.
abstract: BACKGROUND
  Severe health anxiety is a common condition associated with functional disability, making it a costly disorder from a societal perspective. Internet-based cognitive behaviour therapy (ICBT) is a promising treatment but no previous study has assessed the cost-effectiveness or long-term outcome of ICBT for severe health anxiety. The aim of this study was to investigate the cost-effectiveness and 1-year treatment effects of ICBT for severe health anxiety.
  
  
  METHODS
  Cost-effectiveness and 1-year follow-up data were obtained from a randomized controlled trial (RCT) comparing ICBT (n = 40) to an attention control condition (CC, n = 41). The primary outcome measure was the Health Anxiety Inventory (HAI). A societal perspective was taken and incremental cost-effectiveness ratios (ICERs) were calculated using bootstrap sampling.
  
  
  RESULTS
  The main ICER was -£1244, indicating the societal economic gain for each additional case of remission when administering ICBT. Baseline to 1-year follow-up effect sizes on the primary outcome measure were large (d = 1.71-1.95).
  
  
  CONCLUSIONS
  ICBT is a cost-effective treatment for severe health anxiety that can produce substantial and enduring effects.
authors.affiliation: Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. kire.hedman@ki.se
authors.forename: E
authors.initials: E
authors.lastname: Hedman
authors.forename: E
authors.initials: E
authors.lastname: Andersson
authors.forename: N
authors.initials: N
authors.lastname: Lindefors
authors.forename: G
authors.initials: G
authors.lastname: Andersson
authors.forename: C
authors.initials: C
authors.lastname: Rück
authors.forename: B
authors.initials: B
authors.lastname: Ljótsson
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000628:therapy; D001294:Attitude to Health; D015928:Cognitive Behavioral Therapy / Q000191:economics*; D003362:Cost-Benefit Analysis; D003863:Depression / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D006998:Hypochondriasis / Q000191:economics / Q000523:psychology / Q000628:therapy*; D020407:Internet; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D019057:Quality-Adjusted Life Years; D013813:Therapy, Computer-Assisted / Q000191:economics* / Q000379:methods