Warmerdam Lisanne, Smit Filip, van Straten Annemieke, Riper Heleen, Cuijpers Pim
Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, Netherlands.
J Med Internet Res. 2010 Dec 19;12(5):e53. doi: 10.2196/jmir.1436.
The effectiveness of Internet-based treatments for depression has been demonstrated; their cost-effectiveness, however, has been less well researched.
Evaluating the relative cost-utility and cost-effectiveness of (1) Internet-based cognitive behavioral therapy, (2) Internet-based problem-solving therapy, and (3) a waiting list for adults with depressive symptoms.
A total of 263 participants with clinically significant depressive symptoms were randomized to Internet-based cognitive behavioral therapy (n = 88), Internet-based problem-solving therapy (n = 88), and a waiting list (n = 87). End points were evaluated at the 12-week follow-up.
Cost-utility analysis showed that cognitive behavioral therapy and problem-solving therapy had a 52% and 61% probability respectively of being more acceptable than waiting when the willingness to pay is € 30,000 for one quality-adjusted life-year. When society is prepared to pay € 10,000 for a clinically significant change from depression, the probabilities of cognitive behavioral therapy and problem-solving therapy being more acceptable than waiting are 91% and 89%, respectively. Comparing both Internet-based treatments showed no clear preference for one or the other of the treatments.
Both Internet-based treatments have a high probability of being cost-effective with a modest value placed on clinically significant change in depressive symptoms.
ISRCTN16823487; http://www.controlled-trials.com/ISRCTN16823487 (Archived by WebCite at http://www.webcitation.org/5u8slzhDE).
基于互联网的抑郁症治疗方法的有效性已得到证实；然而，其成本效益的研究较少。
评估（1）基于互联网的认知行为疗法、（2）基于互联网的解决问题疗法以及（3）针对有抑郁症状成年人的等待名单的相对成本效用和成本效益。
共有263名有临床显著抑郁症状的参与者被随机分为基于互联网的认知行为疗法组（n = 88）、基于互联网的解决问题疗法组（n = 88）和等待名单组（n = 87）。在12周随访时评估终点。
成本效用分析表明，当支付意愿为每质量调整生命年30,000欧元时，认知行为疗法和解决问题疗法比等待更可接受的概率分别为52%和61%。当社会准备为抑郁症的临床显著改善支付10,000欧元时，认知行为疗法和解决问题疗法比等待更可接受的概率分别为91%和89%。比较两种基于互联网的治疗方法，未显示出对其中一种治疗方法的明显偏好。
两种基于互联网的治疗方法在对抑郁症状的临床显著改善给予适度价值的情况下，具有较高的成本效益可能性。
ISRCTN16823487；http://www.controlled-trials.com/ISRCTN16823487（由WebCite存档于http://www.webcitation.org/5u8slzhDE）
