Cost-Effectiveness of Computer-Assisted Cognitive Behavioral Therapy for Depression
Background
About 1 in 5 adults experience depression, but less than half get help. Those with lower income and education face bigger challenges in accessing treatment. Computer-assisted cognitive behavioral therapy (CCBT) is a helpful and convenient method for treating depression, but we need to understand its cost-effectiveness for diverse populations.
Study Objective
We aimed to compare the cost-effectiveness of clinician-supported CCBT with standard treatment in a primary care setting, focusing on patients with low income and limited internet access.
Study Design
This analysis was part of a randomized clinical trial conducted at the University of Louisville from June 2016 to May 2019. We followed patients with mild to moderate depression for 6 months after treatment. The final assessment was in January 2020.
CCBT Intervention
The CCBT program lasted 12 weeks and included 9 modules on various therapeutic techniques, along with support from a clinician. Standard treatment included regular primary care management.
Main Outcomes
We measured the quality of life using quality-adjusted life years (QALYs) and treatment response based on improvement in depression symptoms. We also considered the costs of therapy, including clinician sessions and necessary technology for patients without resources.
Results
Out of 175 patients, most were female, and a significant portion represented diverse backgrounds. CCBT led to better quality of life and higher treatment response rates compared to standard care. The cost-effectiveness ratio for CCBT was $37,295 per QALY, with a high likelihood (89.4%) of being cost-effective at a threshold of $50,000/QALY.
Conclusions
This study shows that CCBT is a cost-effective option for treating depression in primary care, especially for low-income individuals with limited internet access. These findings are crucial for shaping policies to meet the needs of diverse populations.
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