Department of Psychiatry, Sleep Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Key Laboratory of Mental Health of the Ministry of Education, Southern Medical University, Guangzhou, China.
Sleep. 2024 Aug 14;47(8). doi: 10.1093/sleep/zsae122.
To investigate the cost-effectiveness of cognitive behavioral therapy for insomnia (CBTI), with an additional focus on digital CBTI (dCBTI) in adults with insomnia.
We searched eight electronic databases for economic evaluations of CBTI: PubMed, Scopus, Web of Science, psycINFO, Cochrane, Library, CINAHL, ProQuest, and National Health Service Economic Evaluation Database. Meta-analyses were performed to investigate the effects and costs between CBTI and control groups (no treatment, other treatments included hygiene education and treatment as usual). Subgroup analyses for dCBTI were conducted.
Twelve randomized controlled trial studies between 2004 and 2023 were included in our systematic review and meta-analyses. The incremental cost-utility ratios and incremental cost-effectiveness ratios showed that the CBTI and dCBTI groups were more cost-effective than controls, from healthcare perspective and societal perspective, respectively. Compared to controls, CBTI demonstrated significantly better efficacy within 12 months. Healthcare costs were significantly higher in the CBTI groups compared to the controls within 6 months but there was no difference at 12 months. Additionally, dCBTI was associated with significantly lower presenteeism costs compared to controls at 6 months.
Our findings suggest that CBTI is more cost-effective than other treatments or no treatment for adults with insomnia. It may bring more economic benefits in the long term, especially in long-lasting efficacy and cost reduction. In addition, dCBTI is one of the cost-effective options for insomnia.
CRD42 022 383 440.
Cost-effectiveness of cognitive behavioral therapy for insomnia (CBTI): a systematic review with meta-analysis.
探讨失眠认知行为疗法（CBTI）的成本效益，重点关注失眠成人的数字 CBTI（dCBTI）。
我们在 8 个电子数据库中搜索了关于 CBTI 的经济评估：PubMed、Scopus、Web of Science、psycINFO、Cochrane、图书馆、CINAHL、ProQuest 和英国国家卫生服务经济评估数据库。进行荟萃分析以调查 CBTI 与对照组（无治疗、包括卫生教育和常规治疗的其他治疗）之间的效果和成本。对 dCBTI 进行了亚组分析。
纳入了我们系统评价和荟萃分析的 12 项 2004 年至 2023 年之间的随机对照试验研究。增量成本效用比和增量成本效果比表明，从医疗保健角度和社会角度来看，CBTI 和 dCBTI 组均比对照组更具成本效益。与对照组相比，CBTI 在 12 个月内的疗效显著更好。CBTI 组在 6 个月内的医疗保健成本显著高于对照组，但在 12 个月时没有差异。此外，dCBTI 在 6 个月时与对照组相比，旷工成本显著降低。
我们的研究结果表明，CBTI 对于失眠成人比其他治疗或不治疗更具成本效益。它可能在长期内带来更多的经济效益，特别是在长期疗效和成本降低方面。此外，dCBTI 是失眠的一种具有成本效益的选择。
PROSPERO 注册号：CRD42022383440。
PROSPERO 注册名称：失眠认知行为疗法（CBTI）的成本效益：系统评价与荟萃分析。
