Cost-effectiveness and long-term effectiveness of Internet-based cognitive behaviour therapy for severe health anxiety
Abstract
Background: Severe health anxiety is a common condition associated with functional disability, making it a costly disorder from a societal perspective. Internet-based cognitive behaviour therapy (ICBT) is a promising treatment but no previous study has assessed the cost-effectiveness or long-term outcome of ICBT for severe health anxiety. The aim of this study was to investigate the cost-effectiveness and 1-year treatment effects of ICBT for severe health anxiety. Method: Cost-effectiveness and 1-year follow-up data were obtained from a randomized controlled trial (RCT) comparing ICBT (n = 40) to an attention control condition (CC,n = 41). The primary outcome measure was the Health Anxiety Inventory (HAI). A societal perspective was taken and incremental cost-effectiveness ratios (ICERs) were calculated using bootstrap sampling. Results: The main ICER was −£1244, indicating the societal economic gain for each additional case of remission when administering ICBT. Baseline to 1-year follow-up effect sizes on the primary outcome measure were large (d = 1.71–1.95). Conclusions: ICBT is a cost-effective treatment for severe health anxiety that can produce substantial and enduring effects.
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Cost-utility analyses using quality-adjusted life-years as the primary outcome measure were less conclusive, with CBT showing limited benefit for health-related quality of life.
“In contrast, cost-utility analyses using quality-adjusted life-years (QALYs) as the primary outcome measure were less conclusive, with CBT showing limited benefit for health-related QoL [26–29].”
From Cost Effectiveness of Internet-Delivered Acceptance and Commitment Therapy for Patients with Severe Health Anxiety: A Randomised Controlled Trial (2022) · cites this paper as [27]
Using the Health Anxiety Inventory as the outcome measure, CBT was found to be cost effective regardless of the form of delivery.
“Using the Health Anxiety Inventory (HAI) as the outcome measure, CBT was found to be cost effective regardless of the form of delivery.”
From Cost Effectiveness of Internet-Delivered Acceptance and Commitment Therapy for Patients with Severe Health Anxiety: A Randomised Controlled Trial (2022) · cites this paper as [27]
These findings, as well as the probability of iACT being cost effective interpreted through CEACs, are supported by previous studies reporting similar results using reduction of health anxiety as the cost-effectiveness outcome.
“These findings, as well as the probability of iACT being cost effective interpreted through CEACs, are supported by previous studies reporting similar results using reduction of health anxiety as the cost-effectiveness outcome [27, 28].”
From Cost Effectiveness of Internet-Delivered Acceptance and Commitment Therapy for Patients with Severe Health Anxiety: A Randomised Controlled Trial (2022) · cites this paper as [27]
Only a few studies have examined the costs and cost effectiveness of iCBT programmes for health anxiety, and their control groups, follow-up periods, outcome measures, and methods for economic evaluation differed from those in this study.
“Only a few studies have examined the costs and cost effectiveness of iCBT programmes for health anxiety [16, 27, 30], and their control groups, follow-up periods, outcome measures, and methods for economic evaluation differed from those in our study.”
From Cost Effectiveness of Internet-Delivered Acceptance and Commitment Therapy for Patients with Severe Health Anxiety: A Randomised Controlled Trial (2022) · cites this paper as [27]
These results are similar to previous iCBT studies that reported the same tendency but found no statistically significant differences in costs between groups at follow-up.
“These results are similar to those from the previous iCBT studies [16, 26, 27, 30] that reported the same tendency but found no statistically significant differences in costs between groups at follow-up”
From Cost Effectiveness of Internet-Delivered Acceptance and Commitment Therapy for Patients with Severe Health Anxiety: A Randomised Controlled Trial (2022) · cites this paper as [27]
Internet-delivered CBT can produce large and enduring effects in the treatment of severe health anxiety.
“In a randomized controlled trial, our research group showed that CBT delivered via the Internet can produce large and enduring effects in the treatment of severe health anxiety [11,12].”
From Mediators in Internet-Based Cognitive Behavior Therapy for Severe Health Anxiety (2013) · cites this paper as [11]
The treatment effect of iCBT for severe health anxiety is long-term and cost-effective.
“Studies have also shown that the treatment effect is long-term and cost-effective [18].”
From Development and Feasibility Testing of Internet-Delivered Acceptance and Commitment Therapy for Severe Health Anxiety: Pilot Study. (2018) · cites this paper as [18]
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- Authors
- Hedman, E., Andersson, E., Lindefors, N., Andersson, G., Rück, C., & Ljótsson, B.
- Affiliations
- Karolinska Institutet (SE)
- Linköping University (SE)
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2012-05-21
- Volume
- 43
- Issue
- 2
- Pages
- 363-374
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2160174449
- Cited by
- 98
- References
- 47
- Citations by year
- 2025: 4 · 2024: 3 · 2023: 9 · 2022: 6 · 2021: 6 · 2020: 2 · 2019: 8 · 2018: 5 · 2017: 15 · 2016: 10 · 2015: 8 · 2014: 15 · 2013: 6 · 2012: 1
- FWCI
- 13.45
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Stockholms Läns Landsting
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- health anxiety, internet-based cognitive behavioral therapy, cost-effectiveness, long-term treatment outcomes, social costs, Health Anxiety Inventory, remission
- MeSH terms
- Adult, Aged, Anxiety, Attitude to Health, Cost-Benefit Analysis, Depression, Female, Follow-Up Studies, Humans, Hypochondriasis, Male, Middle Aged, Prospective Studies, Psychiatric Status Rating Scales, Therapy, Computer-Assisted, Cognitive Behavioral Therapy, Health Care Costs, Outcome Assessment, Health Care, Quality-Adjusted Life Years, Internet
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