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Cost-effectiveness of computerised cognitive–behavioural therapy for anxiety and depression in primary care: randomised controlled trial

By Paul McCrone, Martin Knapp, Judith Proudfoot, Clash Ryden, Kate Cavanagh, David A. Shapiro, Sophie Ilson, Jeffrey A. Gray, David Goldberg, Anthony Mann, Isaac Marks, Brian Everitt and Andre Tylee


Background: Cognitive–behavioural therapy (CBT) is effective for treating anxiety and depression in primary care, but there is a shortage of therapists. Computer-delivered treatment may be a viable alternative. Aims: To assess the cost-effectiveness of computer-delivered CBT. Method: A sample of people with depression or anxiety were randomised to usual care (n=128) or computer-delivered CBT (n=146). Costs were available for 123 and 138 participants, respectively. Costs and depression scores were combined using the net benefit approach. Results: Service costs were £40 (90% CI – £28 to £ 148) higher over 8 months for computer-delivered CBT. Lost-employment costs were £407 (90% CI £196 to £586) less for this group. Valuing a 1-unit improvement on the Beck Depression Inventory at £40, there is an 81% chance that computer-delivered CBT is cost-effective, and it revealed a highly competitive cost per quality-adjusted life year. Conclusions: Computer-delivered CBT has a high probability of being cost-effective, even if a modest value is placed on unit improvements in depression

Topics: BF Psychology
Publisher: Royal College of Psychiatrists
Year: 2004
DOI identifier: 10.1192/bjp.185.1.55
OAI identifier:
Provided by: LSE Research Online
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