St. James Ballroom
Cost-Effectiveness Analysis Applied to a Randomized Trial of Remotely Delivered Depression Treatments (303870)
*Elizabeth L. Gray, Northwestern University
Neil Jordan, Northwestern University
Susan Mae Kaiser, Northwestern University
Mary Jeanne Kwasny, Northwestern University
David C. Mohr, Northwestern University
Keywords: ICER, CEAC, cost-effectiveness, depression, telemedicine
Depression is a common illness with a significant cost burden to the health care system. Trained therapists are often not readily available, making treatment difficult to access. Recently telephone-administered cognitive behavioral therapy (tCBT) has been utilized to ease patient burden; however accessibility to therapists remains prohibitive.
We conducted a randomized trial evaluating whether a 20-week long stepped care program, which initiated treatment with internet-CBT (iCBT) and stepped participants up to tCBT only when they did not improve, was non-inferior to tCBT alone. A secondary aim was to determine whether stepped care was more cost-effective compared to tCBT alone.
While non-inferiority analyses are becoming a standard statistical technique, cost-effectiveness analyses (CEA) are more common to the field of health economics. Two components of CEA are incremental cost-effectiveness ratios (ICERs) and cost-effectiveness acceptability curves (CEACs). Utilizing these methods, we demonstrated the relative cost-effectiveness of iCBT over tCBT, thereby showing how an internet-based treatment potentially allows a greater number of people access to quality care.