Table 13:
Cost Estimates for Unguided and Guided iCBT Courses
| Type of iCBT Course | Mean Costs, $a | Total Cost of iCBT Course, $a,b (Low–High)b | |||||
|---|---|---|---|---|---|---|---|
| Licence (Low–High) | Referral | Therapist Training | Therapist Salary | Supervision | Maintenance | ||
| Reference case analysis | |||||||
| Unguided iCBT course | 60–90 | 0c | NA | NA | NA | 77 | 137–167 |
| Therapist-guided iCBT (high intensity) course via portal | 3–5d | 0c | 579 | 114 | 690 | 77 | 1,466–1,470 |
| Therapist-guided iCBT (high intensity) employer-led therapist course via portal | 3–5d | 0c | NA | 114 | 690 | 77 | 887–891 |
| Coach-guided iCBT (low intensity) course | 3–5d | 0c | 579 | 37 | 690 | 77 | 1,389–1,393 |
| Scenario analyses | |||||||
| A. Coach (low intensity) guided iCBT course with referrale | 60–90 | 62.75 | NA | 27 | 517 | 77 | 744–774 |
| B. GP- and coach-guided iCBTf | 3–5d | 62.75 | 579e | 167f | 690 | 77 | 1,582–1,587 |
| C. Employer-led, publicly provided iCBT course | 500–800 | 0c | NA | NA | NA | 77 | 577–877 |
Abbreviations: iCBT, internet-delivered cognitive behavioural therapy, all assumed to have 8 sessions except for the Bounce Back program (6 sessions); NA, not applicable.
All costs were estimated in 2018 Canadian dollars.
Gamma distributions assigned in probabilistic sensitivity analysis, assuming standard error to the mean cost of 25%. Two parameters of the gamma distribution (α, λ) are derived from the mean and standard error. Formulas for these calculations are: α = (Mean‸2)/(SE‸2); λ= Mean/([Mean × SE]‸2).
We assumed patient referred self and costs of assessment were included in price of the program (applicant, in-person communication January 19, 2018).
Costs provided by the applicant (email communication March 24, 2018, and updated in May 2018): these are the monthly costs ($3-$5 per person), the total therapist-guided iCBT assumed 8 weekly sessions of therapy and were accounted in the estimates of the total per-person costs.
Costs estimated for the one example coach-based program in Ontario.
Costs estimated for the primary care iCBT model, enabling a circle of care and assuming that the coach is a family physician (one session/one visit of $62.75).