Web-based intervention for depressive symptoms in adults with types 1 and 2 diabetes mellitus: a health economic evaluation

Br J Psychiatry. 2018 Apr;212(4):199-206. doi: 10.1192/bjp.2018.10.


Background: Web-based interventions are effective in reducing depression. However, the evidence for the cost-effectiveness of these interventions is scarce.AimsThe aim is to assess the cost-effectiveness of a web-based intervention (GET.ON M.E.D.) for individuals with diabetes and comorbid depression compared with an active control group receiving web-based psychoeducation.

Method: We conducted a cost-effectiveness analysis with treatment response as the outcome and a cost-utility analysis with quality-adjusted life-years (QALYs) alongside a randomised controlled trial with 260 participants.

Results: At a willingness-to-pay ceiling of €5000 for a treatment response, the intervention has a 97% probability of being regarded as cost-effective compared with the active control group. If society is willing to pay €14 000 for an additional QALY, the intervention has a 51% probability of being cost-effective.

Conclusions: This web-based intervention for individuals with diabetes and comorbid depression demonstrated a high probability of being cost-effective compared with an active control group.Declaration of interestS.N., D.D.E., D.L., M.B. and B.F. are stakeholders of the Institute for Online Health Trainings, which aims to transfer scientific knowledge related to this research into routine healthcare.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cognitive Behavioral Therapy* / economics
  • Cognitive Behavioral Therapy* / methods
  • Comorbidity
  • Cost-Benefit Analysis*
  • Depression* / economics
  • Depression* / epidemiology
  • Depression* / therapy
  • Depressive Disorder* / economics
  • Depressive Disorder* / epidemiology
  • Depressive Disorder* / therapy
  • Diabetes Mellitus, Type 1* / economics
  • Diabetes Mellitus, Type 1* / epidemiology
  • Diabetes Mellitus, Type 2* / economics
  • Diabetes Mellitus, Type 2* / epidemiology
  • Female
  • Humans
  • Internet
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Quality-Adjusted Life Years
  • Telemedicine* / economics
  • Telemedicine* / methods