Economic evaluations of internet- and mobile-based interventions for the treatment and prevention of depression: A systematic review
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.
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IMIs have been shown to be effective and cost-effective across several mental health conditions.
“IMIs have been shown to be effective and cost-effective across several mental health conditions [10–14].”
From Impact of an acceptance facilitating intervention on psychotherapists' acceptance of blended therapy (2020) · cites this paper as [13]
A growing body of research supports the efficacy of Internet-based interventions for the treatment of depression.
“A growing body of research supports the efficacy of Internet-based interventions (IBIs) for the treatment of depression (17, 20–24).”
Emerging evidence supports the cost-effectiveness of guided digital mental health treatments.
“Emerging evidence supports the cost-effectiveness of guided DMHTs (20, 41).”
From Banbury forum consensus statement on the path forward for digital mental health treatment (2021) · cites this paper as [41]
DMHIs allow people to access psychotherapy skills and content in their own time and empower them to self-manage their symptoms.
“DMHIs allow people to access psychotherapy skills and content in their own time and empower them to self-manage their symptoms [7-11].”
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Economic evaluation of healthcare interventions: old and new directions: Table 1:
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Internetbasierte psychologische Interventionen
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Prevention of depression in chronically physically ill adults
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Self-citationKaryotaki, E., Tordrup, D., Buntrock, C., Bertollini, R., & Cuijpers, P. J. (2016) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796016000421 · Cited by 19 · see citing works
Self-citationDie Berechnung von Kosten und Nutzen
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What You Ask is What You Get: Willingness-to-Pay for a QALY in GermanyPreprint
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How You Ask is What You Get: Willingness-to-Pay for a QALY in GermanyPreprint
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Ergebnisse zu Kosten und Nutzen der Psychotherapie
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Kein signifikanter Zusatznutzen als Add-on in der allgemeinärztlichen Routineversorgung
Baumeister, H. (2016) · InFo Neurologie + Psychiatrie · doi:10.1007/s15005-016-1601-3 · Cited by 2 · see citing works
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Digital interventions for the treatment of depression: a meta-analytic review
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Self-citationAndersson, G., Carlbring, P., Titov, N., & Lindefors, N. (2019) · The Canadian Journal of Psychiatry · doi:10.1177/0706743719839381 · Cited by 324 · see citing works
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e-Addictology: An Overview of New Technologies for Assessing and Intervening in Addictive Behaviors
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Ebert, D. D., Harrer, M., Apolinário-Hagen, J., & Baumeister, H. (2019) · Advances in Experimental Medicine and Biology · doi:10.1007/978-981-32-9721-0_29 · Cited by 76 · see citing works
Self-citation(2019) · Europe PMC (PubMed Central) · Cited by 72 · see citing works
Li, J., Parrott, S., Sweeting, M. J., Farmer, A. A., Ross, J., Dack, C., Pal, K., Yardley, L., Barnard, M., Hudda, M. T., et al. (2018) · Journal of Medical Internet Research · doi:10.2196/jmir.9256 · Cited by 72 · see citing works
Sander, L. B., Paganini, S., Terhorst, Y., Schlicker, S., Lin, J., Spanhel, K., Buntrock, C., Ebert, D. D., & Baumeister, H. (2020) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2020.1021 · Cited by 63 · see citing works
Self-citationDigital mental health interventions for depression
Himle, J. A., Weaver, A., Zhang, A., & Xiang, X. (2022) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2020.12.009 · Cited by 65 · see citing works
Kählke, F., Buntrock, C., Smit, F., & Ebert, D. D. (2022) · npj Digital Medicine · doi:10.1038/s41746-022-00702-w · Cited by 66 · see citing works
Self-citationSmith, J. S., Faux, S. G., Gardner, T., Hobbs, M. J., James, M., Joubert, A. E., Kladnitski, N., Newby, J. M., Schultz, R., Shiner, C. T., et al. (2019) · Pain Medicine · doi:10.1093/pm/pnz208 · Cited by 59 · see citing works
Baumeister, H., Paganini, S., Sander, L. B., Lin, J., Schlicker, S., Terhorst, Y., Moshagen, M., Bengel, J., Lehr, D., & Ebert, D. D. (2021) · Psychotherapy and Psychosomatics · doi:10.1159/000511881 · Cited by 55 · see citing works
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Impact of an acceptance facilitating intervention on psychotherapists' acceptance of blended therapy
Baumeister, H., Terhorst, Y., Grässle, C., Freudenstein, M., Nübling, R., & Ebert, D. D. (2020) · PLoS ONE · doi:10.1371/journal.pone.0236995 · Cited by 53 · see citing works
Self-citationInternet-Based Interventions in Chronic Somatic Disease
Bendig, E., Bauereiß, N., Ebert, D. D., Snoek, F., Andersson, G., & Baumeister, H. (2018) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.2018.0659 · Cited by 54 · see citing works
Self-citationDigital interventions in mental health: Evidence syntheses and economic modelling
Gega, L., Jankovic, D., Saramago, P., Marshall, D., Dawson, S., Brabyn, S., Nikolaidis, G. F., Melton, H., Churchill, R., & Bojke, L. (2022) · Health Technology Assessment · doi:10.3310/rcti6942 · Cited by 48 · see citing works
mHealth applications: potentials, limitations, current quality and future directions
Messner, E.-M., Probst, T., O’Rourke, T., Stoyanov, S., & Baumeister, H. (2019) · Studies in neuroscience, psychology and behavioral economics · doi:10.1007/978-3-030-31620-4_15 · Cited by 49 · see citing works
Edge, D., Watkins, E. R., Limond, J., & Mugadza, J. (2023) · Behaviour Research and Therapy · doi:10.1016/j.brat.2023.104292 · Cited by 42 · see citing works
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Self-citationKüchler, A.-M., Albus, P., Ebert, D., & Baumeister, H. (2019) · Internet Interventions · doi:10.1016/j.invent.2019.100245 · Cited by 34 · see citing works
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Paganini, S., Lin, J., Kählke, F., Buntrock, C., Leiding, D., Ebert, D. D., & Baumeister, H. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-023390 · Cited by 31 · see citing works
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Wu, Q., Li, J., Parrott, S., López-López, J. A., Davies, S. R., Caldwell, D. M., Churchill, R. C., Peters, T. J., Lewis, G., Tallon, D., et al. (2020) · Value in Health · doi:10.1016/j.jval.2020.07.008 · Cited by 19 · see citing works
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Schlicker, S., Weisel, K. K., Buntrock, C., Berking, M., Nobis, S., Lehr, D., Baumeister, H., Snoek, F. J., Riper, H. M., & Ebert, D. D. (2019) · Journal of Diabetes Research · doi:10.1155/2019/2634094 · Cited by 20 · see citing works
Self-citationMorello, K., Schäfer, S. K., Kunzler, A. M., Priesterroth, L., Tüscher, O., & Kubiak, T. (2023) · Frontiers in Digital Health · doi:10.3389/fdgth.2023.1253390 · Cited by 23 · see citing works
Kählke, F., Berger, T., Schulz, A., Baumeister, H., Berking, M., Cuijpers, P. J., Bruffaerts, R., Auerbach, R. P., Kessler, R. C., & Ebert, D. D. (2019) · BMC Psychiatry · doi:10.1186/s12888-019-2125-4 · Cited by 19 · see citing works
Self-citationDigital interventions in adult mental healthcare settings: recent evidence and future directions
Dülsen, P., Bendig, E., Küchler, A., Christensen, H. M., & Baumeister, H. (2020) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000614 · Cited by 18 · see citing works
Self-citationBraun, L., Titzler, I., Terhorst, Y., Freund, J., Thielecke, J., Ebert, D. D., & Baumeister, H. (2021) · Internet Interventions · doi:10.1016/j.invent.2021.100455 · Cited by 18 · see citing works
Self-citationE-mental health applications for depression: an evidence-based ethical analysis
Rubeis, G. (2021) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-019-01093-y · Cited by 17 · see citing works
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Economic Evaluation of Cognitive Behavioral Therapy for Depression: A Systematic Review
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Internet Interventions in Clinical Psychology
Andersson, G., & Carlbring, P. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-818697-8.00211-9 · Cited by 15 · see citing works
Schuster, R., Fischer, E., Jansen, C., Napravnik, N., Rockinger, S., Steger, N., & Laireiter, A.-R. (2022) · Internet Interventions · doi:10.1016/j.invent.2022.100551 · Cited by 15 · see citing works
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Angerer, F., Mennel, V., Grund, S., Mayer, A., Büscher, R., Sander, L., Cuijpers, P. J., Terhorst, Y., Baumeister, H., & Domhardt, M. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.09.055 · Cited by 15 · see citing works
Self-citationBuntrock, C. (2024) · Frontiers in Digital Health · doi:10.3389/fdgth.2024.1486728 · Cited by 14 · see citing works
Self-citationKrämer, L. V., Grünzig, S.-D., Baumeister, H., Ebert, D. D., & Bengel, J. (2021) · Psychotherapy and Psychosomatics · doi:10.1159/000515625 · Cited by 14 · see citing works
Self-citationGräfe, V., Berger, T., Hautzinger, M., Hohagen, F., Lutz, W., Meyer, B., Moritz, S., Rose, M., Schröder, J., Späth, C., et al. (2019) · Health Economics Review · doi:10.1186/s13561-019-0233-y · Cited by 14 · see citing works
Assessing the costs and cost-effectiveness of ICare internet-based interventions (protocol)
Beecham, J., Bonin, E.-M., Görlich, D., Baños, R., Beintner, I., Buntrock, C., Bolinski, F., Botella, C., Ebert, D. D., Herrero, R., et al. (2019) · Internet Interventions · doi:10.1016/j.invent.2018.02.009 · Cited by 13 · see citing works
Self-citationvan Luenen, S., Kraaij, V., Garnefski, N., Spinhoven, P., & van Marle, M. E. V. D. A. –. (2019) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2019.01.012 · Cited by 13 · see citing works
Cognitive remediation for depression vulnerability: Current challenges and new directions
Zwalmen, Y. V., Hoorelbeke, K., Liebaert, E., de Mévergnies, C. N., & Koster, E. H. W. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.903446 · Cited by 14 · see citing works
Lunkenheimer, F., Ebert, D. D., & Baumeister, H. (2023) · Springer eBooks · doi:10.1007/978-3-662-65816-1_19 · Cited by 13 · see citing works
Self-citationHennemann, S., Böhme, K., Baumeister, H., Bendig, E., Kleinstäuber, M., Ebert, D. D., & Witthöft, M. (2018) · BMJ Open · doi:10.1136/bmjopen-2018-024929 · Cited by 12 · see citing works
Self-citationLange, O. (2023) · BMC Health Services Research · doi:10.1186/s12913-023-09280-3 · Cited by 12 · see citing works
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Baumeister, H., & Montag, C. (2022) · Studies in neuroscience, psychology and behavioral economics · doi:10.1007/978-3-030-98546-2_1 · Cited by 12 · see citing works
Self-citationBuntrock, C., Kählke, F., Smit, F., & Ebert, D. D. (2019) · European Journal of Public Health · doi:10.1093/eurpub/ckz022 · Cited by 11 · see citing works
Self-citationGuided Internet-Delivered Treatment for Depression: Scoping Review
Børtveit, L., Dechsling, A., Sütterlin, S., Nordgreen, T., & Nordahl‐Hansen, A. (2022) · JMIR Mental Health · doi:10.2196/37342 · Cited by 11 · see citing works
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Nowrouzi‐Kia, B., Bani‐Fatemi, A., Jackson, T., Li, A., Chattu, V. K., Lytvyak, E., Deibert, D., Dennett, L., Ferguson-Pell, M., Hagtvedt, R., et al. (2024) · Journal of Occupational Rehabilitation · doi:10.1007/s10926-024-10246-3 · Cited by 7 · see citing works
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Self-citationKrämer, L. V., Mueller-Weinitschke, C., Zeiss, T., Baumeister, H., Ebert, D. D., & Bengel, J. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-054775 · Cited by 7 · see citing works
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mHealth Applications: Potentials, Limitations, Current Quality and Future Directions
Meßner, E.-M., Probst, T., O’Rourke, T., Stoyanov, S. R., & Baumeister, H. (2022) · Studies in neuroscience, psychology and behavioral economics · doi:10.1007/978-3-030-98546-2_18 · Cited by 6 · see citing works
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- Authors
- Paganini, S., Teigelkötter, W., Buntrock, C., & Baumeister, H.
- Affiliations
- University of Freiburg (DE)
- Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
- Universität Ulm (DE)
- Corresponding author
- Paganini, Sarah
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2018-01
- Volume
- 225
- Pages
- 733-755
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2735986931
- Cited by
- 144
- References
- 113
- Citations by year
- 2026: 5 · 2025: 11 · 2024: 11 · 2023: 18 · 2022: 22 · 2021: 19 · 2020: 23 · 2019: 21 · 2018: 13 · 2017: 1
- FWCI
- 1.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Bundesministerium für Bildung und Forschung (01GY1330A)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- online intervention, mobile-based interventions, depression treatment, depression prevention, cost-effectiveness, major depressive disorder, subthreshold depression, minor depression, guided intervention, quality-adjusted life years, willingness-to-pay threshold, risk of bias
- MeSH terms
- Cost-Benefit Analysis, Depression, Major Depressive Disorder, Humans, Magnetic Resonance Imaging, Treatment Outcome, Quality-Adjusted Life Years, Internet
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