JMIR Publications

ABSTRACT

Background:

Internet-based cognitive behavioral therapy (CBT) provides psychological interventions to individuals with emotional needs while avoiding stigmatization and embarrassment from face-to-face interaction at the clinical setting.

Objective:

This study aimed to examine the potential cost-effectiveness of internet-based guided-CBT in university students with mild depressive symptoms from the perspective of service provider in Hong Kong.

Methods:

The outcomes of low-intensity guided internet-based CBT and in-person CBT in a hypothetical cohort of university students with mild depressive symptoms were examined by a five-year decision-analytic model. Model inputs were obtained from published literature and local data. Model outcomes included direct medical cost, school dropouts and quality-adjusted life year (QALY). Sensitivity analyses were conducted on all model parameters.

Results:

Compared to the in-person group, the internet group gained higher QALYs by 0.0211 QALYs, lowered school dropouts by 0.052%, and saved USD249 in the base-case analysis. In one-way sensitivity analysis, the internet group gained higher QALYs at lower cost than in-person group throughout the variation of all model inputs. Probabilistic sensitivity analysis showed that the internet group was cost-effective (at willingness-to-pay threshold USD48,119/QALY) in 99.7% of the 10,000 Monte Carlo simulations.

Conclusions:

Internet-based CBT appears to be the cost-effective option when compared to in-person CBT for university students with mild depressive symptoms from the perspective of service provider in Hong Kong.