Economic evaluations of internet- and mobile-based interventions for the treatment and prevention of depression: A systematic review

Sarah Paganini; Wiebke Teigelkötter; Claudia Buntrock; Harald Baumeister

doi:10.1016/j.jad.2017.07.018

Economic evaluations of internet- and mobile-based interventions for the treatment and prevention of depression: A systematic review

J Affect Disord. 2018 Jan 1:225:733-755. doi: 10.1016/j.jad.2017.07.018. Epub 2017 Jul 18.

Authors

Sarah Paganini¹, Wiebke Teigelkötter², Claudia Buntrock³, Harald Baumeister⁴

Affiliations

¹ Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Germany. Electronic address: sarah.paganini@psychologie.uni-freiburg.de.
² Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Germany.
³ Department of Clinical Psychology and Psychotherapy, University of Erlangen-Nuremberg, Germany.
⁴ Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Germany.

PMID: 28922737
DOI: 10.1016/j.jad.2017.07.018

Abstract

Background: Internet- and mobile-based interventions (IMIs) targeting depression have been shown to be clinically effective and are considered a cost-effective complement to established interventions. The aim of this review was to provide an overview of the evidence for the cost-effectiveness of IMIs for the treatment and prevention of depression.

Methods: A systematic database search was conducted (Medline, PsychInfo, CENTRAL, PSYNDEX, OHE HEED). Relevant articles were selected according to defined eligibility criteria. IMIs were classified as cost-effective if they were below a willingness-to-pay threshold (WTP) of €22,845 (£20,000) - €34,267 (£30,000) per additional quality-adjusted life year (QALY) according to the National Institute for Health and Clinical Excellence (NICE) standard. Study quality was assessed using the Consolidated Health Economic Evaluation Reporting Standard guidelines and the Cochrane Risk of Bias Tool.

Results: Of 1538 studies, seven economic evaluations of IMIs for the treatment of major depression, four for the treatment of subthreshold/minor depression and one for the prevention of depression. In six studies, IMIs were classified as likely to be cost-effective with an incremental cost-utility ratio between €3088 and €22,609. All of these IMIs were guided. Overall quality of most economic evaluations was evaluated as good. All studies showed some risk of bias.

Limitations: The studies used different methodologies and showed some risk of bias. These aspects as well as the classification of cost-effectiveness according to the WTP proposed by NICE should be considered when interpreting the results.

Conclusions: Results indicate that guided IMIs for the treatment of (subthreshold) depression have the potential to be a cost-effective complement to established interventions, but more methodologically sound studies are needed.

Keywords: Cost-effectiveness; Depression; E-health; Prevention; Systematic review; Treatment.

Publication types

Review
Systematic Review

MeSH terms

Cost-Benefit Analysis
Depression / prevention & control
Depression / therapy*
Depressive Disorder, Major / therapy
Humans
Internet*
Magnetic Resonance Imaging
Quality-Adjusted Life Years
Treatment Outcome