Rohrbach P, Dingemans A, Evers C, Van Furth E, Spinhoven P, Aardoom J, Lähde I, Clemens F, Van den Akker-Van Marle M. Cost-effectiveness of Internet Interventions Compared With Treatment as Usual for People With Mental Disorders: Systematic Review and Meta-analysis of Randomized Controlled Trials. J Med Internet Res 2023;25:e38204. DOI: 10.2196/38204
A systematic review and meta-analysis were conducted to investigate the cost-effectiveness of internet interventions for mental disorders compared to usual care. Eligibility criteria for included studies were randomized controlled trials with participants who reported any mental health disorder or symptoms, an intervention that was phone- or internet-based, reported outcomes on both quality of life and costs, and published in English. Researchers extracted data to report risk of bias, quality of the economic evaluation, quality-adjusted life years, and costs. The incremental net monetary benefit was calculated and pooled. Thirty-seven studies met eligibility criteria. Overall, the quality of economic evaluations was rated as moderate and the risk of bias as high. Internet interventions were slightly more effective in improving quality of life than usual care (Hedges g=0.052, p=.02) but with similar cost (Hedges g=0.002, p=.96). The pooled incremental net benefit was $255 (95% CI $91 to $419), favoring internet interventions over usual care. This review is a starting point for researchers to further understand the cost-effectiveness of internet interventions for mental disorders. Future work could investigate studies with more homogenous interventions or designs. Additionally, studies from non-Western cultures or low-income countries were not included in this review. To conclude, the cost-effectiveness of internet interventions compared with usual care is likely but not guaranteed.