Guided internet-based cognitive behavioral therapy for insomnia: Health-economic evaluation from the societal and public health care perspective alongside a randomized controlled trial

Buntrock C, Lehr D, Smit F, Horvath H, Berking M, Spiegelhalder K, Riper H, Ebert DD (2021)

Publication Type: Journal article

Publication year: 2021

Journal

Journal of Medical Internet Research Journal of Medical Internet Research / Gunther Eysenbach

Book Volume: 23

Article Number: e25609

Journal Issue: 5

DOI: 10.2196/25609

Abstract

Background: The evidence base for internet-based cognitive behavioral therapy for insomnia (iCBT-I) is firm; however, little is known about iCBT-I's health-economic effects. Objective: This study aimed to evaluate the cost-effectiveness and cost-utility of iCBT-I in reducing insomnia among schoolteachers. Methods: Schoolteachers (N=128) with clinically significant insomnia symptoms and work-related rumination were randomized to guided iCBT-I or a wait list control group, both with unrestricted access to treatment as usual. Health care use, patient and family expenditures, and productivity losses were self-assessed and used for costing from a societal and a public health care perspective. Costs were related to symptom-free status (score <8 on the insomnia severity index) and quality-adjusted life years (QALYs) gained. Sampling error was handled using nonparametric bootstrapping. Results: Statistically significant differences favoring the intervention group were found for both health outcomes (symptom-free status yes or no: β=.30; 95% CI 0.16-0.43; QALYs: β=.019, 95% CI 0.01-0.03). From a societal perspective, iCBT-I had a 94% probability of dominating the wait list control for both health outcomes. From a public health care perspective, iCBT-I was more effective but also more expensive than the wait list control, resulting in an incremental cost-effectiveness ratio of €650 per symptom-free individual. In terms of QALYs, the incremental cost-effectiveness ratio was €11, 285. At a willingness-to-pay threshold of €20, 000 per QALY gained, the intervention's probability of being cost-effective was 89%. Conclusions: Our trial indicates that iCBT could be considered as a good value-for-money intervention for insomnia.

Authors with CRIS profile

Claudia Buntrock Lehrstuhl für Klinische Psychologie und Psychotherapie Matthias Berking Lehrstuhl für Klinische Psychologie und Psychotherapie

Additional Organisation(s)

Lehrstuhl für Klinische Psychologie und Psychotherapie

Involved external institutions

Leuphana Universität Lüneburg DE Germany (DE) Trimbos Institute NL Netherlands (NL) HelloBetter GET.ON Institut für Online Gesundheitstrainings GmbH DE Germany (DE) Albert-Ludwigs-Universität Freiburg DE Germany (DE) Vrije Universiteit Amsterdam (VU) / University Amsterdam NL Netherlands (NL) Technische Universität München (TUM) DE Germany (DE)

How to cite

APA:

Buntrock, C., Lehr, D., Smit, F., Horvath, H., Berking, M., Spiegelhalder, K.,... Ebert, D.D. (2021). Guided internet-based cognitive behavioral therapy for insomnia: Health-economic evaluation from the societal and public health care perspective alongside a randomized controlled trial. Journal of Medical Internet Research, 23(5). https://dx.doi.org/10.2196/25609

MLA:

Buntrock, Claudia, et al. "Guided internet-based cognitive behavioral therapy for insomnia: Health-economic evaluation from the societal and public health care perspective alongside a randomized controlled trial." Journal of Medical Internet Research 23.5 (2021).

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