Internet-Based Mental Health Intervention for Depressive Symptoms in Young Adults: Cost-Effectiveness Analysis.

Background: Internet-based cognitive behavioral therapy (CBT) provides psychological interventions to individuals with mild depressive symptoms. Objective: This study aimed to examine the potential cost-effectiveness of internet-based guided-CBT in university students with mild depressive symptoms from the perspective of service providers in Hong Kong. Methods: The outcomes of low-intensity guided internet-based CBT and in-person CBT in a hypothetical cohort of university students with mild depressive symptoms were examined using a 5-year decision-analytic model. Model inputs were obtained from published literature and local data. Model outcomes included direct medical cost, school dropouts, and quality-adjusted life years (QALYs). Sensitivity analyses were conducted on all model parameters. Results: Compared to the in-person group, the internet group gained higher QALYs by 0.0211 QALYs, lowered school dropouts by 0.052%, and saved US $249 in the base-case analysis. In one-way sensitivity analysis, the internet group gained higher QALYs at a lower cost than the in-person group throughout the variation of all model inputs. Probabilistic sensitivity analysis showed that the internet group was cost-effective (at willingness-to-pay threshold was US $48,119/QALY) in 99.7% of the 10,000 Monte Carlo simulations. Conclusions: Internet-based CBT appears to be the cost-effective option when compared to in-person CBT for university students with mild depressive symptoms from the perspective of service providers in Hong Kong.