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Cost-effectiveness and long-term effectiveness of Internet-based cognitive behaviour therapy for severe health anxiety

Published online by Cambridge University Press:  21 May 2012

E. Hedman ,
E. Andersson ,
N. Lindefors ,
G. Andersson ,
C. Rück  and
B. Ljótsson
E. Hedman*
Affiliation:
Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden Osher Centre for Integrative Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
E. Andersson
Affiliation:
Division of Psychiatry, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
N. Lindefors
Affiliation:
Division of Psychiatry, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
G. Andersson
Affiliation:
Division of Psychiatry, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden
C. Rück
Affiliation:
Division of Psychiatry, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
B. Ljótsson
Affiliation:
Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
*
*Address for correspondence: E. Hedman, Ph.D., Karolinska Institutet, Department of Clinical Neuroscience, SE-171 77 Stockholm, Sweden. (Email: [email protected])
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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.

Keywords

Cognitive behaviour therapycost-effectivenesshealth anxietyInternet
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 2 , February 2013 , pp. 363 - 374
Copyright
Copyright © Cambridge University Press 2012

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