University of Coimbra, Center for Research in Neuropsychologu and Cognitive Behavioral Intervention, Faculty of Psychoogy and Educational Sciences, Coimbra, Portugal.
Centre for Health Studies and Research, Faculty of Economics, University of Coimbra, Coimbra, Portugal.
Int J Technol Assess Health Care. 2022 Jul 21;38(1):e62. doi: 10.1017/S0266462322000447.
Web-based interventions for the promotion of maternal mental health could represent a cost-effective strategy to reduce the burden associated with perinatal mental illness. This study aimed to evaluate the cost-utility of Be a Mom, a self-guided web-based cognitive behavioral therapy intervention, compared with a waiting-list control.
The economic evaluation alongside a randomized controlled trial was conducted from a societal perspective over a 14-month time frame. Postpartum women presenting low risk for postpartum depression were randomized to the intervention ( = 191) or control ( = 176) group and assessed at baseline, postintervention and 4 and 12 months after postintervention. Data regarding healthcare use, productive losses and quality-adjusted life years (QALYs) were collected and used to calculate incremental cost-effectiveness ratios (ICERs). Uncertainty was accounted for with nonparametric bootstrapping and sensitivity analyses.
At 14 months, and after accounting for a 3.5 percent discount rate, the intervention resulted in a yearly cost-saving of EUR 165.47 (-361.77, 28.51) and a QALY gain of 0.0064 (-0.0116, 0.0244). Bootstrapping results revealed a dominant ICER for the intervention group. Although results were statistically nonsignificant, cost-effectiveness acceptability curves showed that at a EUR 0 willingness to pay threshold, there is a 96 percent probability that the intervention is cost-effective when compared with the control group. The sensitivity analyses generally supported the acceptable likelihood of the intervention being more cost-effective than the control group.
From a societal perspective, the implementation of Be a Mom among low-risk postpartum women could be a cost-effective way to improve perinatal mental health.
促进产妇心理健康的基于网络的干预措施可能是减轻与围产期精神疾病相关负担的一种具有成本效益的策略。本研究旨在评估 Be a Mom （一种自我引导的基于网络的认知行为疗法干预措施）与等待名单对照相比的成本效用。
这项经济评估与一项随机对照试验同时进行，从社会角度在 14 个月的时间框架内进行。有低产后抑郁风险的产后妇女被随机分配到干预组（n=191）或对照组（n=176），并在基线、干预后以及干预后 4 个月和 12 个月进行评估。收集有关医疗保健使用、生产损失和质量调整生命年（QALY）的数据，并用于计算增量成本效益比（ICER）。使用非参数引导和敏感性分析来考虑不确定性。
在 14 个月时，考虑到 3.5%的贴现率，干预导致每年节省 165.47 欧元（-361.77，28.51），并获得 0.0064 个 QALY 的增益（-0.0116，0.0244）。引导结果显示干预组具有主导性的 ICER。尽管结果在统计学上无显著性，但成本效益可接受性曲线表明，在 0 欧元的意愿支付阈值下，与对照组相比，干预措施具有 96%的可能性具有成本效益。敏感性分析通常支持干预措施比对照组更具成本效益的可能性。
从社会角度来看，在低风险产后妇女中实施 Be a Mom 可能是改善围产期心理健康的一种具有成本效益的方法。
