Accepted for/Published in: JMIR Mental Health
Date Submitted: Nov 22, 2019
Open Peer Review Period: Nov 22, 2019 - Nov 29, 2019
Date Accepted: Mar 25, 2020
(closed for review but you can still tweet)
Long-Term Effectiveness and Cost-Effectiveness of Videoconference-Delivered Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder, Panic Disorder, and Social Anxiety Disorder in Japan: One-Year Follow-Up of the Single-Arm Trial
ABSTRACT
Background:
Face-to-face individual cognitive behavioral therapy (CBT) and internet-based CBT (ICBT) without videoconferencing are known to have long-term effectiveness for obsessive-compulsive disorder (OCD), panic disorder (PD), and social anxiety disorder (SAD). However, videoconference-delivered CBT (VCBT) has not been investigated regarding its long-term effectiveness and cost-effectiveness.
Objective:
The purpose of this study was to investigate the long-term effectiveness and cost-effectiveness of VCBT for patients with OCD, PD, or SAD in Japan, using one-year follow up in our previous 16-week single-arm study.
Methods:
Written informed consent was obtained from25 of 29 eligible patients with OCD, PD, and SAD who had completed VCBT in our previous clinical trial. The participants were assessed at baseline, end of treatment, and at follow-up endpoints of 3 months, 6 months, and 12 months. Outcomes were the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Panic Disorder Severe Scale (PDSS), Liebowitz Social Anxiety Scale (LSAS), the Patients Health Questionnaire-9 (PHQ-9), the General Anxiety Disorder-7 (GAD-7), and the EuroQol-5D-5L (EQ-5D-5L). To analyze cost-effectiveness, we employed relevant public data and derived data on VCBT implementation costs from Japanese national health insurance data.
Results:
Four males and 21 females with an average age of 35.1 years (SD = 8.6) participated in the one-year follow up study. Principal diagnoses were OCD (n=10), PD (n=7), and SAD (n=8). The change at 12 months in Y-BOCS was −4.1 (P = 0.04), the change in PDSS was −4.4 (P = .001), and the change in LSAS was −30.9 (P = 0.01). The change in the PHQ-9 at 12 months was −2.7 (P = 0.007), and the change in the GAD-7 was −3.0 (P = 0.009). QALY at 12 months was 0.7469 (SE = 0.0353, 95% Cl: 0.6728 – 0.821), and the change was a significant increase to 0.0379 (P = 0.01). Total costs to provide the VCBT were JPY 60,800 to JPY 81,960 per patient. The set threshold was JPY 189,500 (USD 1,722.73; EUR 1,579.17; GBP 1,353.57) calculated based on willingness to pay in Japan.
Conclusions:
VCBT was a cost-effective way to effectively treat Japanese patients with OCD, PD, or SAD.
Citation
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