Table 18:

Cost–Utility Analysis, Sequential Approach: Internet-Delivered CBT, In-Person CBT, and Usual Care for Major Depression

Strategy	Mean Costs, $a	Mean QALYs	Incremental Costs, $a,b	Incremental QALYsc	ICER, $/QALY Gaineda
Unguided iCBT	274.65	0.778	—	—	—
Usual care	409.40	0.787	134.75	0.009	14,972
Guided iCBT (therapist)	1,666.26	0.826	1,256.86	0.039	31,575
Group CBT	1,691.23	0.817	24.97	–0.009	Dominatedd
Individual CBT	2,654.00	0.826	987.79	0.00001	59,377,114e

Abbreviations: CBT, cognitive behavioural therapy; iCBT, internet-delivered CBT; ICER, incremental cost-effectiveness ratio; QALY, quality-adjusted life-year.

^aAll costs in 2018 Canadian dollars. No discounting was done given the 12-month time horizon.

^bIncremental cost = average cost (strategy of guided CBT) – average cost (strategy of usual care).

^cIncremental effect = average effect (strategy of guided CBT) – average effect (strategy of usual care).

^dNegative ICER means this strategy was considered dominated and was excluded from the analysis.

^eThis estimate of the high ICER implies that individual CBT was just slightly better when it comes to QALY increments and is essentially dominated by guided iCBT because it provides benefit almost equal to that of guided iCBT, but it is more costly.

Note: Results may appear incorrect because of rounding.