| Duarte et al, 201737; Littlewood et al, 2015,36 United Kingdom |
Individual-level cost–utility analysis Pragmatic multicentre, open, three-arm, parallel RCT with simple randomisation; REEACT UK NHS Time horizon: 18 months Discount rate: 3.5%
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≥18 yr with prevalent or new major depression (PHQ-9 score of ≥10) not using psychotherapy at baseline (N = 691) Beating the Blues, MoodGYM, control Mean age: 39.61 (SD12.34), 39.43 (SD 12.96), and 40.52 (SD 12.64), respectively Beating the Blues vs MoodGYM vs control Female participants: 67.62%, 64.88%, and 68.20%, respectively Most participants with moderate depression: PHQ-9 = 17; prior major depression: 68% to 75%; prior antidepressant use: 85% to 89%; prior anxiety: 79% to 81%
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Interventions: (1) Beating the Blues, a commercial pay-to-use iCBT program, plus usual GP care (n = 210), or (2) MoodGYM, a free-to-use iCBT program, plus usual GP care (n = 242) Comparator: usual GP care (n = 239) Unguided and low-intensity guided iCBT: (1) Beating the Blues, a 15-min introductory video followed by eight 50-min therapy sessions, with homework exercises between sessions, or 2) MoodGYM, 6 interactive modules/sessions (30–45 min each) Both groups had low-intensity (technical) weekly phone support/calls to engage and troubleshoot the programs (not therapy) GP care according to NICE guidelines, stepped care, use of medications, or other psychotherapies if necessary (6% to 7% of participants took medications)
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Beating the Blues, MoodGYM, and control: Total QALYs (measured by EQ-5D): 1.33 (SD 0.037), 1.36 (SD 0.03), and 1.39 (SD 0.03), respectively Beating the Blues vs usual care: Adjusted mean difference: −0.043 (95% CI −0.12 to 0.03) Intervention vs usual care Mean QALYs at 18 mo: 1.0 (SD 0.3) vs 1.0 (SD 0.3) MoodGYM vs usual care Adjusted mean difference: −0.015 (95% CI −0.09 to 0.06)
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Currency: £ Year: 2011–2012 Beating the Blues vs usual care Total costs (mean): 104.2 (95% CI −67 to 276) MoodGYM vs usual care Mean difference: −106.1 (95% CI −262 to 49) Beating the Blues Software licensing cost estimated at £50 per user MoodGYM Software licensing cost estimated at £0.66 per user The cost of iCBT included costs associated with the number and duration of phone calls (£21unit cost per hour)
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Base-case analysis: Neither iCBT program with minimal technical guidance (Beating the Blues or MoodGYM plus usual GP care) was cost-effective (dominant) compared with usual care alone Probabilities of cost-effectiveness at wtp £20,000 per QALY: 54% usual GP care, 42% MoodGYM, and 4% Beating the Blues Sensitivity analysis of 3 scenarios: Scenario 1, SF-6D—source for QALYs: MoodGYM dominated usual GP care; probabilities of cost-effectiveness at wtp £20,000 per QALY: 24% usual GP care, 75% MoodGYM, and 1% Beating the Blues; however, increments in QALYs for MoodGYM vs usual GP care not statistically significant mean: (0.006, 95% CI −0.03 to 0.05) Scenario 2: Inclusion of depression-treatment costs only: usual GP care remains the dominant strategy Scenario 3: complete case analysis: usual GP care remains the dominant strategy
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| Romero-Sanchiz et al, 2017,43 Spain |
Individual-level cost–utility and cost-effectiveness analyses A pragmatic, multicentre (30 primary care centers), open, three-arm, parallel RCT Societal perspective • Time horizon: 12 months Discount rate: 0%
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Intervention: Smiling is Fun Unguided iCBT “ (n = 98), low-intensity therapist-guided iCBT (n = 96) Comparator: Improved TAU by a GP (n = 102) (GPs received 3-hr training in how to treat depression based on the NICE recommendations), including medications iCBT: 10 modules at 1/wk Unguided iCBT included technical help without therapist support Guided iCBT included trained psychotherapist, help over email
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Total QALYs (mean per person, by EQ-5D-3L) At baseline (P = .435 Guided iCBT: 0.6794 (SD ±0.18) Unguided iCBT: 0.6989 (SD ±0.14) Control: 0.7076(SD ±0.1482) At 12 mo (P = 0.13) Guided iCBT: 0.7883 (SD ±0.21) Unguided iCBT: 0.7852 (SD ±0.24) Control: 0.7059(SD ±0.22): Mean difference Guided iCBT vs control: 0.0824 Unguided iCBT vs control: 0.0824/0.0793
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Currency: € Year: 2014 Total costs (mean), guided iCBT/unguided iCBT/control, baseline vs 12 mo: 2,627 (SD ±3,199)/3,119 (SD ±3,125)/2,892 (SD ±2,890), P = 0.537 vs 1,757 (SD ±3,636)/1,308 (SD ±2,219)/1,716 (SD ±2,437), P = 0.467 Mean difference Guided iCBT/unguided iCBT vs control: 40.9/–409.2
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Base-case analysis: Guided/unguided iCBT vs control, ICER: 497/5,160 per QALY Probability of iCBT being cost-effective compared with control for a wtp of 21,000 to 25,000 per QALY: high, exact values NR
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| Lee et al, 2017,49 Australia |
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Intervention: guided iCBT through Online MindSpot Clinic, “Well-being Course” Comparators: usual care, waitlist control 4–6-session course delivered over 8 wk with homework assignments and weekly support from clinicians plus reminders byautomated emailand phone Clinic data (costs and utilities as measured by EQ-5D) were used in the decision-tree model
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Currency, Australian $ year: 2014 Total costs (mean), iCBT vs control: (1) Excluding hospitalization costs: 472.75 vs 488.04 (2) Including hospitalization costs: 472.75 vs 849.57 Mean difference: (1) Excluding hospitalization costs: 15.29 (2) Including hospitalization costs: 376.82 Total annual cost of attending Mindspot clinic: 391.60
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Base-case analysis: ICER: cost saving, dominant Probability of iCBT being cost-effective: NR One-way deterministic analyses and scenarios: the ICER remained cost-effective (<10,000/QALY gained)
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| Brabyn et al, 2016,38 United Kingdom |
Individual-level cost–utility analysis A pragmatic, multicentre, open, two-arm, parallel RCT; REEACT-2 NHS and PSS perspective Time horizon: 12 mo Discount rate: 0%
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≥18 yrs with moderate major depression (PHQ-9 score of ≥10) no psychotherapy at baseline (N = 369) -
Mean age:
Guided iCBT: 41.0 (SD ±13.8)
Unguided iCBT: 40.3 (SD ±3.7)
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Female:
Guided iCBT: 67%
Unguided iCBT: 62%
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Most patients with moderate depression: PHQ-9 score of 17
Prior major depression: 70% to 72%
Prior antidepressant use: 39%
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Intervention: guided iCBT: weekly supportive/facilitative phone calls plus MoodGYM (n = 242) Comparator: MoodGYM, unguided, minimally supported (technical only) (n = 239) -
MoodGYM: 6 interactive modules/sessions to be completed weekly (30–45 min each), plus homework. First 5 interactive modules released sequentially, with a 6th session for consolidation and revision
Additional support: phone facilitation and guidance, manualized/scripted, 10 and 20 min weekly to engage and motivate participants 8 phone calls over 12–14 wk, between first contact and 4-mo follow-up.
Trained non-regulated phone support workers are do not provide any CBT
10-member early psychosis team consistingpsychiatrists, psychologists, occupational therapists, nurses, and health care assistants specifically trained in early psychosis
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Total QALYs (measured by EQ-5D), guided vs unguided iCBT at 12 mo: 0.700 (SD ±0.016) vs. 0.686 (SD ±0.019) Adjusted mean difference, guided vs unguided iCBT: 0.0026
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Currency: £
Year: 2012–2013
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Total costs (mean):
Guided iCBT: 1,172 (SD ±186.5)
Unguided iCBT: 1,763 (438.8)
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Mean difference, guided vs unguided iCBT:
All costs: −3.42
Direct medical costs: 9.37
Non-medical costs of guided iCBT per patient: 42
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Base-case analysis, including multiple imputations:
All costs: guided iCBT was dominant
Direct medical costs: 3,596/QALY
Probability of cost-effectiveness of guided vs unguided iCBT at wtp 20,000 or 30,000 per QALY was 55% -
Missing data at 12 mo: 59%
All analyses included multiple imputations
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| Dixon et al, 2016,39 United Kingdom |
Individual-level cost–utility analysis Multicentre, open, parallel, two-arm, individually randomized RCT NHS and PSS perspective Time horizon: 12 months Discount rate: 0%
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≥18 yrs with mild to moderate major depression (N = 609), primary care setting Mean age: iCBT: 50.0 Control: 49.1 Females: iCBT: 69% Control: 68% >87% were prescribed an antidepressant at baseline; >91% were previously treated for depression
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Intervention: Living Life to the Full, a coach-guided iCBT, program (n = 307) Comparator: usual care (n = 302) Intervention was provided in 2 stages: Pre-therapy (max 4 weekly sessions by CBT-assistant nurse) CBT therapy (max 26 weekly sessions) iCBT: self-directed over 4 mo, with an option of phone support for up to 10 calls over 12 mo by a trained coach (non-regulated health care professional, supervised by nursing staff and pharmacists); participants also had access to a secure web portal including health information, and access to the Big White Wall online forum
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Total QALYs (mean, by EQ-5D-5L adjusted for baseline utility) with imputations: iCBT: 0.541 (SD ±0.009) Usual care: 0.541 (SD ±0.009) Mean difference adjusted for baseline differences, with imputations: 0.001 (95% CI −0.023 to 0.026) Total QALYs (mean, by EQ-5D-5L) complete case analysis: iCBT: 0.535 Usual care: 0.573 Mean difference adjusted for baseline differences, QALY, complete case analysis: 0.037 (95% CI 0.009–0.066) Missing data >50% in both effectiveness and cost outcomes; data imputated using multiple imputation techniques
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-
Currency: £
Year: 2012–2013
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Total costs (mean):
With imputations:
iCBT: 886
Usual care: 718
Complete case analysis:
iCBT: 864
Usual care: 719
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Mean difference: With imputations: 168 (95% CI 43–294)
Complete case analysis: 145 (95% CI −11 to 300)
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Intervention-related costs:
Training costs and encounter (phone) calls, non-scheduled calls, CBT book (if needed), after imputation of the missing data: £113.0 Software license: £9.7 and Phone calls: £71.7
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Base-case analysis, with imputations: iCBT vs usual care: ICER: £132,630 per QALY INB at a wtp threshold of £20,000/QALY gained: −£143 (95% CI −164 to −122) Probability of iCBT being cost-effective compared with usual care: wtp of £20,000 per QALY: 30% wtp of £30,000 per QALY: 37%. ICER remained robust (not cost-effective) in scenario analyses that exclude the costs of the online forum; however, ICER was cost-effective in the complete case analysis: £3,850 per QALY (>98% probability of cost-effectiveness at NHS wtp threshold) The study authors questioned the value of the complete case analysis and consider it biased
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| Titov et al, 2015,44 Australia |
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Australian residents ≥60 yrs with non-severe depression (PHQ-9 scores 10–19), referred by GP (N = 54) Mean Age iCBT: 64.52 (SD ±2.58) Waitlist control: 66.16 (SD ±3.80) Females iCBT: 81.5% Waitlist control: 64% Mixed population of anxiety disorders, 90% major depression and/or GAD Participants on medications: not reported
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Intervention: Managing Your Mood, iCBT plus email and phone support from a senior therapist (n = 27) Comparator: waitlist control (n = 25) 5-sessions delivered over 8 wks plus support from psychotherapist (10 min weekly)
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Currency: AUD Year: 2013 Total costs (mean): iCBT: 198.6 (95% CI 155.5–292.3) Control: 146.6 (95% CI 80.8–250.6) Mean difference: 52.04 (–23.8 to 128.2) Total therapist time (mean): 45.07 (SD ±32.51)
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Base-case analysis: ICER: $4,392 per QALY (95% CI <063,962) Probability of iCBT being cost-effective compared with waitlist control at wtp of $50,000 per QALY: >95% Probability of iCBT being cost-effective compared with waitlist control at wtp of $4,392 per QALY: 50%
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| Geraedts et al, 2015,45 Netherlands |
Individual-level cost-effectiveness, cost–utility and cost-benefit analyses Open RCT, individual block randomization Employer and societal perspectives Time horizon: 12 mo Discount rate: 0%
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Adults, employees, with mild to moderate depression, CES-D = 25 at baseline (N = 231), 6 companies Mean age: iCBT: 43 (SD ±8.9) TAU: 43.8 (SD ±9.6) Females iCBT: 77% TAU: 67%
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Intervention: Happy@Work guided – iCBT (n = 116) Comparator: TAU, email referral to employee (participant) with advice to seek treatment for their symptoms (n = 115) iCBT: minimal guidance web-based program, 6 sessions plus one booster session, homework assigned; coach available to provide feedback on the assignment; a tunneled intervention allowing participants to start with a new session only after getting feedback on their prior homework; coaches (MSc students trained in clinical psychology) used a manualized protocol and all feedback was reviewed by a supervisor; all participants were allowed to seek additional mental health care
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Total QALYs (mean per person) at 12 mo: iCBT: 0.79 (SD ± 0.02) TAU: 0.78 (SD ± 0.02) Mean difference, QALY: −0.001 (95% CI −0.04 to 0.04) Mean difference: Point change in CES-D: −2.3 (95% CI −4.3 to −0.3) Clinically significant change: 0.1 (95% CI 0.0 to 0.2) Total benefits (occupational health, absenteeism, and presentism, mean per person), iCBT vs TAU: 793
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Currency: € Year: 2012 Total costs (mean), societal perspective: CCBT, iCBT: 22,402 (SD ±1,953) TAU: 23,115 (SD ±1,357) Mean difference, iCBT vs TAU: −714 (–5,018 to 3,924) iCBT cost: 236 per user
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Base-case analysis, societal perspective ICERs: 532,959/QALY lost (every QALY lost was associated with savings of 532,959) 314/point decrease in depressive symptoms €6,645/clinically significant improvement in depressive symptoms Probability of iCBT being cost-effective compared with TAU at any wtp per QALY: 62% -
Cost-benefit analysis: benefit-to-cost ratio = 2.8 (P > .05)
For every € invested, the employer received €2.8 back for an ROI of 178% (P > .05); the iCBT intervention probability of return: 63%
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| Solomon et al, 2015,48 Australia |
Cost–utility analysis Model-based analysis NR perspective Time horizon: 6 months Discount rate: 0%
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Adults with mild to moderate depression, anxiety, and/or stress Mean age: not reported Females: not reported Stepped-care that reflects Australian and national guidelines within 28 wks: 7-wk treatment during acute phase, and 21-wk treatment during maintenance phase; decision tree reflected probabilities of compliance to treatment, drop-out, relapse, switch to other therapy, and initial remission and remission in the maintenance phase
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Intervention: “My Compass,” unguided iCBT during acute phase plus 21-wk maintenance phase consisting of booster internet-delivered program (monitoring of symptoms, behaviours, and lifestyle factors) Comparators: Face-to-face CBT with a clinical psychologist for acute phase over 7 wk, and TAU: drug treatment in the acute phase and after remission in the maintenance phase CBT: 16 sessions during the 3-mo acute phase and 2 “booster” sessions after Model: Participants not compliant to iCBT switch to TAU or face-to-face CBT Participants not compliant to face-to-face CBT switch to TAU (drugs: most commonly prescribed antidepressants based on administrative data) Participants not responding to TAU switch to another drug; those who switch treatment either enter remission or discontinue treatment All patients have consultations with GP at prescribed intervals (2–3 visits per cycle) to monitor their symptoms; some have monthly psychiatric consults (based on an average rate of 0.3% and 10.6%)
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Total QALYs: iCBT: 0.26 (95% CI 0.15–0.34) Face-to-face CBT: 0.29 (95% CI 0.16–0.37) Pharmacotherapy (TAU): 0.24 (95% CI 0.15–0.32) Mean difference, iCBT vs face-to-face CBT compared to TAU: 0.02 and 0.03
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Currency: AUD Year: 2013–2014 Total costs (mean): iCBT: 334.96 (95% CI 332.01–338.75) Face-to-face CBT: 2,330.51 (95% CI 2,201.10–2,408.40) TAU: 3,645 (95% CI 457.05–619.77) Mean difference, iCBT vs face-to-face CBT, compared to TAU: 1,996 and 158
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Base-case analysis: iCBT vs face-to-face CBT, iCBT vs TAU: ICER (face-to-face CBT vs iCBT): AUD 66,518/QALY; ICER (iCBT vs pharmacotherapy): cost-saving Probability of iCBT being cost-effective at wtp of $50,000 per QALY: 75.5% when compared to both TAU and face-to-face CBT 97%, against TAU 97% at any threshold value Face-to-face CBT is the most efficient at wtp of $65,000 per QALY: 80.3%. -
Sensitivity analyses: EVPI: $79.37 per patient
EVPPI: the rate of non-adherence to iCBT needs further research iCBT would not be cost-effective at $50,000/QALY if the cost of iCBT increased from $56 to $309 or if the cost of face-to-face CBT decreased from $734 to $309
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| Phillips et al, 2014,41 United Kingdom |
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Adults with mild depression (N = 637) Mean age (overall): 43 yr Females (overall): 48% to 50%
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Intervention: MoodGYM, unguided iCBT (n = 318) Comparator: self-help via mental health websites (n = 319) Five 1-hr sessions of CBT, delivered weekly via software application
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| Gerhards et al, 2010,46 Netherlands |
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18–65 yr with mild to moderate depression (N = 303), primary care setting Mean age: iCBT: 44.3 (SD ±11.8) iCBT plus TAU: 45.2 (SD ±10.9) TAU: 45.1 (SD ±12.2) Females iCBT: 52% iCBT plus TAU: 63% TAU: 55.3%
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Interventions: Color Your Life, unguided iCBT (n = 100) vs unguided iCBT plus TAU (n = 100) Comparator: TAU (n = 103) iCBT: 8 sessions plus one booster session, no therapist support • Usual care consisted of 4–5 biweekly consultations with a GP, antidepressants added if indicated
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Total QALYs (mean per person, corrected for baseline utility): iCBT: 0.71 (SD ±0.17) iCBT plus TAU: 0.71 (SD ±0.14) TAU: 0.72 (SD ±0.16) Mean difference, QALY: 0.01, P = .842
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Currency: € Year: 2007 Total costs (mean, societal perspective): iCBT: 9,457 (7,547–11,506) iCBT plus TAU: 10,793 (8,412–13,328) TAU: 11,244 (9,206–13,419) Mean difference, iCBT vs TAU: −711 (–3,111 to 1,780) iCBT plus TAU vs TAU: 738 (–1,871 to 3,477) iCBT vs iCBT plus TAU: −1449 (–4,309 to 1282) iCBT cost: €50 per user
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Base-case analysis, ICER not reported Probability of iCBT being cost-effective compared with TAU: 65% at wtp of €0 per QALY 40% at wtp of €80,000 per QALY; at this threshold TAU intersects and has the same 40% probability of cost-effectiveness Results remained similar in sensitivity analyses
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| Warmerdam et al, 2010,47 Netherlands |
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Intervention: iCBT (n = 88), internet-based PST (n = 88) Comparator: waitlist control (n = 87) iCBT: 8-session course delivered weekly, plus a booster session after 12 weeks PST: 5 sessions delivered weekly Both interventions: participants supported by life coach via email, therapists spent 20 minutes per week on each participant
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Total QALYs (mean per person) iCBT: 0.16 (95% CI 0.152–0.169) PST: 0.16 (95% CI −0.152 to 0.168) Control: 0.15 (95% CI −0.142 to 0.159) Mean difference, iCBT vs waitlist control and PST vs waitlist control: 0.01
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Currency: € Year: 2007 Total costs (mean), iCBT: 2,814 (SD ±2,683) PST: 2,705 (SD ±2,851) -
Mean difference, iCBT vs waiting list: 256 (2,814 to 2,558)
PST vs waiting list: 147 (2,705 to 2,558)
Total treatment costs: iCBT: 501 PST: 338
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Base-case analysis, iCBT vs waitlist control: ICER: €22,609 per QALY; €1,817 per one additional reliably improved participant (clinically significant change in depression symptom severity) Probability of iCBT being cost-effective compared with waitlist control at wtp of €30,000 per QALY: 52%
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| Hollinghurst et al, 2010,40 United Kingdom |
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18–75 yr with major depression (N = 297), primary care setting Mean age: 34.9 (SD ±11.6) Females: 68% >50% were prescribed an antidepressant
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Intervention: therapist-guided iCBT plus usual care (n = 149) Comparator: usual care, waitlist control (n = 148) iCBT: up to 10 sessions, 55 mins each, over 4 mo; therapist supported with access to on-line psychologist; Mean number of on-line sessions: 6.1 (SD ±3.8)
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Total QALYs (mean per person): Therapist-guided iCBT plus usual care: 0.522 (SD ±0.012) Usual care: 0.495 (SD ±0.016) Mean difference, QALY: 0.027 (–0.012 to 0.066) % recovered (BDI <10): Therapist-guided iCBT plus usual care: 31% Usual care: 19% Mean difference, % recovered: 13.3 (–3.4 to 30)
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Currency: £ Year: 2007 Total costs (mean): iCBT: 764 (SD ±380) Usual care: 295 (SD ±359) Mean difference, iCBT vs usual care: 469 (95% CI 342–597) Total treatment costs: iCBT: 493 (SD ±185); therapists were paid 40/hr, on-line psychologist service was paid 11; overhead charge was negotiated 11 (would be £20); supervision cost: 62.50/hr
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Base-case analysis: iCBT vs waitlist control, ICER: 17,173 per QALY; 3528 per extra participant Probability of iCBT being cost-effective compared with waitlist control: 56% at wtp of 20,000 per QALY 71% at wtp of 30,000 per QALY ICER was below the base case estimate in sensitivity analyses (accounting for imputed data, excluding hospital costs, and with max costs of iCBT)
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| Kaltenthaler et al, 2006,50 United Kingdom |
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Adults with major depression and/or anxiety, non-severe depression, or depression Mean age: NR Females: NR Model accounted for different severity levels of depression and associated costs: licence fees, computer hardware, screening of patients for suitability, clinical support, capital overhead (for facilities for computer and clinician) and the training of staff
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Interventions: Beating the Blues (for major depression and/or anxiety) Cope (for non-severe depression) Overcoming depression (for depression) Usual GP care according to NICE guidelines, stepped-care approach) Beating the Blues: a 15-min introductory video followed by eight 50-minute therapy sessions, with homework exercises between sessions Cope: 3-mo program with 5 main treatment modules Overcoming Depression: a CD-ROM-based CBT system, six 45–50 min sessionswith support from a nurse-clinician
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Total QALYs: Beating the Blues: 1.10 Cope: 1.05 Overcoming depression: 1.03 TAU: 1.02 Mean difference: Beating the Blues vs. usual care: 0.08 Cope vs. usual care: 0.03 Overcoming depression vs usual care: 0.01 Mean difference, Beating the blues vs usual care by depression severity: Mild: 0.07 Moderate: 0.08 Severe: 0.08
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Currency: £ Year: NR Total costs (mean): Beating the Blues: 584 Cope: 630 Overcoming depression: 501 TAU: 437 Mean difference: iCBT vs waiting list: 256 (2,814–2,558) PST vs waiting list: 147 (2,705–2,558) Mean difference vs. usual care: Beating the Blues: 147 Cope: 193 Overcoming depression: 64 Mean difference, Beating the blues vs usual care by depression severity: Mild: 131 Moderate: 157 Severe: 154 Estimated costs per participant: Beating the Blues, one copy: 219.3 (152.4–353.0) Cope, home access: 171.3 (122.7–268.2) Overcoming depression, one copy: 72.6 (42.4–133.0)
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Base-case anaysis (ICER): Beating the Blues vs. TAU: 1801 per QALY Cope vs. TAU: 7139 per QALY Overcoming depression vs TAU: 5391 per QALY Probability of treat being cost effective at wtp £30,000 per QALY: Beating the Blues: 87% Cope: 63% Overcoming depression: 54%
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| McCrone et al, 2004,42 United Kingdom |
Individual-level cost–utility and cost-effectiveness analyses Open RCT, primary care setting involving 12 GP practices in south-east England NHS perspective Time horizon: 8 months Discount rate: 0%
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18–75 yrs with prevalent or new major depression or anxiety who are not using psychotherapy at baseline (N = 261) Mean age: Beating the Blues: 43.6 (SD ±14.4) Control: 43.7 (SD ±13.7) Females: Beating the Blues: 73% Control: 74%
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Intervention: 1) a commercial pay-to-use iCBT program (Beating the Blues) plus usual GP care (n=123) Comparator: Usual GP care (n = 138) Beating the Blues: a 15-minute introductory video followed by eight 50-minute therapy sessions with homework exercises between sessions
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Total QALYs (mean), iCBT plus usual care vs usual care: NR The mean difference, depression-free days, iCBT vs. TAU: 28.4 (10.7–45.5) The estimated mean difference (QALYs), iCBT vs. TAU: 0.032
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Currency: £ Year: 1999–2000 Total costs (mean) at 8 mo: Beating the Blues: 397 (SD ±589) Usual care: 357 (SD ±575) Mean difference: 40 (–28 to 148) Beating the Blues software license per session was estimated at 14.50 (5–30 in sensitivity analysis)
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Base-case analysis: ICER: 40 per unit reduction, 1,333/QALY Probability of Beating the Blues being cost-effective: 80% at wtp 0 per unit reduction 85% at wtp 5,000 per QALY
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