Cognitive-Behavioral Therapy for Depression May Be More Cost-Effective Than Prozac

1998 ◽  
Author(s):  
D. O. Antonuccio ◽  
M. Thomas ◽  
W. G. Danton
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cost Effective ◽  
Cognitive Behavioral

Cost-effectiveness of digital cognitive behavioral therapy (Sleepio) for insomnia: a Markov simulation model in the United States

SLEEP ◽  
2020 ◽  
Author(s):  
Michael Darden ◽  
Colin A Espie ◽  
Jenna R Carl ◽  
Alasdair L Henry ◽  
Jennifer C Kanady ◽  
...  
Keyword(s):  
United States ◽  
Cost Effectiveness ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cost Effective ◽  
The United States ◽  
Cognitive Behavioral ◽  
Life Years ◽  
Insomnia Treatment ◽  
Group Cbt

Abstract Study Objectives To examine the cost-effectiveness and potential net monetary benefit (NMB) of a fully automated digital cognitive behavioral therapy (CBT) intervention for insomnia compared with no insomnia treatment in the United States (US). Similar relative comparisons were made for pharmacotherapy and clinician-delivered CBT (individual and group). Methods We simulated a Markov model of 100,000 individuals using parameters calibrated from the literature including direct (treatment) and indirect costs (e.g. insomnia-related healthcare expenditure and lost workplace productivity). Health utility estimates were converted into quality-adjusted life years (QALYs) and one QALY was worth $50,000. Simulated individuals were randomized equally to one of five arms (digital CBT, pharmacotherapy, individual CBT, group CBT, or no insomnia treatment). Sensitivity was assessed by bootstrapping the calibrated parameters. Cost estimates were expressed in 2019 US dollars. Results Digital CBT was cost beneficial when compared with no insomnia treatment and had a positive NMB of $681.06 (per individual over 6 months). Bootstrap sensitivity analysis demonstrated that the NMB was positive in 94.7% of simulations. Relative to other insomnia treatments, digital CBT was the most cost-effective treatment because it generated the smallest incremental cost-effectiveness ratio (−$3,124.73). Conclusions Digital CBT was the most cost-effective insomnia treatment followed by group CBT, pharmacotherapy, and individual CBT. It is financially prudent and beneficial from a societal perspective to utilize automated digital CBT to treat insomnia at a population scale.

Cognitive-Behavioral Therapy for Eating Disorders

2017 ◽  
Author(s):  
G. Terence Wilson
Keyword(s):  
Eating Disorders ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cost Effective ◽  
Cognitive Behavioral ◽  
Dissemination And Implementation ◽  
Research Priority ◽  
Self Help ◽  
Effective Dissemination ◽  
Further Development

This chapter discusses cognitive-behavioral therapy (CBT) as applicable to all eating disorders in adults and adolescents. It reviews the most recent manual-based enhanced CBT (CBT-E), which not only appears to be more effective than the previous protocol but also is applicable to all eating disorders and enhances individualizing treatment even within specific diagnoses. The chapter considers the effectiveness of CBT compared to behavior weight loss treatment, pharmacotherapy, and interpersonal psychotherapy (IPT). It considers patient access to evidence-based CBT and discusses effective dissemination and implementation of competently administered CBT-E as a research priority. It describes and considers the effectiveness of a guided self-help form of CBT (CBTgsh), which provides a brief, cost-effective, acceptable, and scalable intervention. It describes possible further development of CBTgsh as a scalable e-therapy (using Internet and mobile devices) given that it is a program-based intervention that can be widely implemented by nonspecialists.

scholarly journals Is bouldering-psychotherapy a cost-effective way to treat depression when compared to group cognitive behavioral therapy – results from a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Larissa Schwarzkopf ◽  
Lisa Dorscht ◽  
Ludwig Kraus ◽  
Katharina Luttenberger
Keyword(s):  
Cost Effectiveness ◽  
Cognitive Behavioral Therapy ◽  
Rating Scale ◽  
Behavioral Therapy ◽  
Productivity Loss ◽  
Cost Effective ◽  
Routine Care ◽  
Cognitive Behavioral ◽  
Distributed Model ◽  
Depression Symptoms

Abstract Background Bouldering-Psychotherapy (BPT) has proven to effectively reduce depressive symptoms, but evidence on its cost-effectiveness is lacking. Corresponding information is paramount to support health policy decision making on a potential implementation of BPT in routine care. Methods Using data from the German KuS trial BPT was compared with group Cognitive Behavioral Therapy (CBT). Severity of depression symptoms at end of the intervention was operationalized via Montgomery-Asberg Depression Rating Scale (MADRS) and Patient Health Questionnaire (PHQ-9). Adopting a societal perspective, direct medical costs and productivity loss were calculated based on standardized unit costs. To determine incremental cost-effectiveness ratios (ICER) and cost-effectiveness-acceptance curves (CEAC), adjusted mean differences (AMD) in costs (gamma-distributed model) and both effect parameters (Gaussian-distributed model) were obtained from 1000 simultaneous bootstrap replications. Results BPT was related to improved effects (AMDs: MADRS -2.58; PHQ-9: − 1.35) at higher costs (AMD: +€ 754). No AMD was significant. ICERs amounted to €288 per MADRS-point and €550 per PHQ-9-point. For both effect parameters about 20% of bootstrap replications indicated dominance of BPT, and about 75% larger effects at higher costs. At hypothetical willingness to pay (WTP) thresholds of €241 (MADRS) and €615 (PHQ-9) per unit of change BPT had a 50% probability of being cost-effective. Conclusion BPT is a promising alternate treatment strategy which – in absence of established WTP thresholds for improving symptoms of depression – cannot unambiguously be claimed cost-effective. Further studies defining subgroups that particularly benefit from BPT appear paramount to delineate recommendations for an efficient prospective roll-out to routine care.

scholarly journals Cost-effectiveness of guided internet-based cognitive behavioral therapy compared with usual care for depression: results from an implementation project (Preprint)

2021 ◽  
Author(s):  
Jordi Piera-Jiménez ◽  
Anne Etzelmueller ◽  
Spyros Kolovos ◽  
Frans Folkvord ◽  
Francisco Lupiáñez-Villanueva
Keyword(s):  
Cost Effectiveness ◽  
Cognitive Behavioral Therapy ◽  
Usual Care ◽  
Transition Probabilities ◽  
Behavioral Therapy ◽  
Scale Up ◽  
Cost Effective ◽  
Cognitive Behavioral ◽  
Sensitivity Analyses ◽  
The Cost

BACKGROUND Major depressive disorder (MDD) is a chronic condition whereby the prevalence is expected to grow with the aging trend of high-income countries. Internet-based cognitive-behavioral therapy (iCBT) has proven efficacy in treating MDD. OBJECTIVE The objective of this study was to assess the cost-effectiveness of implementing a community-based iCBT intervention (Super@, the Spanish program for the MasterMind project) for treating MDD. METHODS The cost-effectiveness of the Super@ program was assessed with the Monitoring and Assessment Framework for the European Innovation Partnership on Active and Healthy Ageing (MAFEIP) tool, using a 3-state Markov model. Data from the cost and effectiveness of the intervention were prospectively collected from the implementation of the program by a healthcare provider in Badalona (Spain); the corresponding data for usual care were gathered from the literature. The health states, transition probabilities, and utilities were computed using the scores of the patient health questionnaire 9 (PHQ-9). RESULTS The analysis was performed using data from 229 participants using the Super@ program. Results showed that the intervention was more costly than usual care; the 3%-discounted and non-discounted incremental cost-effectiveness ratios (ICERs) were € 29,367 and € 26,484 per quality-adjusted life-year (QALY), respectively. The intervention was cost-effective based on the 30K willingness-to-pay (WTP) threshold typically applied in Spain. According to the deterministic sensitivity analyses, the potential reduction of costs associated with intervention scale-up would reduce the ICER of the intervention, although it remained more costly than usual care. A discount in the incremental effects up to 5% exceeded the WTP threshold of 30K. CONCLUSIONS The Super@ program, an iCBT intervention for treating MDD, was more costly than TAU. Still, its implementation in Spain would be cost-effective from the healthcare and societal perspective at a WTP threshold of 30K compared with TAU. CLINICALTRIAL Not applicable

Cognitive Behavioral Therapy for Depression

2021 ◽  
Author(s):  
Stirling Moorey ◽  
Steven D. Hollon
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Cognitive Therapy ◽  
Behavioral Activation ◽  
Behavioral Therapy ◽  
Cost Effective ◽  
Evidence Base ◽  
Cognitive Change ◽  
Cognitive Behavioral ◽  
Emotional States ◽  
Effective Dissemination

Cognitive behavioral therapy (CBT) has the strongest evidence base of all the psychological treatments for depression. It has been shown to be effective in reducing symptoms of depression and preventing relapse. All models of CBT share in common an assumption that emotional states are created and maintained through learned patterns of thoughts and behaviors and that new and more helpful patterns can be learned through psychological interventions. They also share a commitment to empirical testing of the theory and clinical practice. Beck’s Cognitive Therapy sees negative distorted thinking as central to depression and is the most established form of CBT for depression. Behavioral approaches, such as Behavioral Activation, which emphasize behavioral rather than cognitive change, also has a growing evidence base. Promising results are emerging from therapies such as Mindfulness Based Cognitive Therapy (MBCT) and rumination-focused therapy that focus on the process of managing thoughts rather than their content. Its efficacy-established CBT now faces the challenge of cost-effective dissemination to depressed people in the community.

Cognitive Behavioral Therapy for Eating Disorders

2001 ◽  
Author(s):  
Glenn Waller ◽  
Helen Cordery ◽  
Emma Corstorphine ◽  
Hendrik Hinrichsen ◽  
Rachel Lawson ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral
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