Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden.
Behav Res Ther. 2011 Nov;49(11):729-36. doi: 10.1016/j.brat.2011.07.009. Epub 2011 Jul 29.
Social anxiety disorder (SAD) is highly prevalent and associated with a substantial societal economic burden, primarily due to high costs of productivity loss. Cognitive behavior group therapy (CBGT) is an effective treatment for SAD and the most established in clinical practice. Internet-based cognitive behavior therapy (ICBT) has demonstrated efficacy in several trials in recent years. No study has however investigated the cost-effectiveness of ICBT compared to CBGT from a societal perspective, i.e. an analysis where both direct and indirect costs are included. The aim of the present study was to investigate the cost-effectiveness of ICBT compared to CBGT from a societal perspective using a prospective design. We conducted a randomized controlled trial where participants with SAD were randomized to ICBT (n=64) or CBGT (n=62). Economic data were assessed at pre-treatment, immediately following treatment and six months after treatment. Results showed that the gross total costs were significantly reduced at six-month follow-up, compared to pre-treatment in both treatment conditions. As both treatments were equivalent in reducing social anxiety and gross total costs, ICBT was more cost-effective due to lower intervention costs. We conclude that ICBT can be more cost-effective than CBGT in the treatment of SAD and that both treatments reduce societal costs for SAD.
社交焦虑障碍（SAD）的患病率很高，给社会带来了巨大的经济负担，主要是因为生产力损失的成本很高。认知行为团体治疗（CBGT）是治疗 SAD 的有效方法，也是临床实践中最成熟的方法。近年来，几项试验已经证明了基于互联网的认知行为疗法（ICBT）的疗效。然而，从社会角度（即包括直接和间接成本的分析）比较 ICBT 和 CBGT 的成本效益的研究尚未进行。本研究旨在采用前瞻性设计，从社会角度调查 ICBT 与 CBGT 的成本效益。我们进行了一项随机对照试验，将 SAD 患者随机分为 ICBT（n=64）或 CBGT（n=62）组。在治疗前、治疗后即刻和治疗后 6 个月评估经济数据。结果表明，与治疗前相比，两种治疗方法在 6 个月随访时的总费用均显著降低。由于 ICBT 的干预成本较低，且两种治疗方法在降低社交焦虑和总费用方面效果相当，因此 ICBT 更具成本效益。我们的结论是，在治疗 SAD 方面，ICBT 可能比 CBGT 更具成本效益，而且两种治疗方法都可以降低 SAD 的社会成本。
