Cost-effectiveness of internet-based cognitive-behavioural therapy and physical exercise for depression

Martin Kraepelien, Simon Mattsson, Erik Hedman-Lagerlöf, Ingemar F. Petersson, Yvonne Forsell, Nils Lindefors, Viktor Kaldo

Research output: Contribution to journalArticlepeer-review


Background Both internet-based cognitive-behavioural therapy (ICBT) and physical exercise are alternatives to treatment as usual (TAU) in managing mild to moderate depression in primary care.Aims To determine the cost-effectiveness of ICBT and physical exercise compared with TAU in primary care.Method Economic evaluation of a randomised controlled trial (N = 945) in Sweden. Costs were estimated by a service use questionnaire and used together with the effects on quality-adjusted life-years (QALYs). The primary 3-month healthcare provider perspective in primary care was complemented by a 1-year societal perspective.Results The primary analysis showed that incremental cost per QALY gain was €8817 for ICBT and €14 571 for physical exercise compared with TAU. At the established willingness-to-pay threshold of €21 536 (£20 000) per QALY, the probability of ICBT being cost-effective is 90%, and for physical exercise is 76%, compared with TAU.Conclusions From a primary care perspective, both ICBT and physical exercise for depression are likely to be cost-effective compared with TAU.Declaration of interest None.

Original languageEnglish
Pages (from-to)265-273
Number of pages9
JournalBJ Psych Open
Issue number4
Publication statusPublished - 2018

Subject classification (UKÄ)

  • Psychiatry
  • Public Health, Global Health, Social Medicine and Epidemiology

Free keywords

  • Cognitive-behavioural therapies
  • cost-effectiveness
  • depressive disorders
  • exercise
  • randomised controlled trial


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