Article Abstract

Article Abstract

Online ISSN: 1099-176X Print ISSN: 1091-4358
The Journal of Mental Health Policy and Economics
Volume 20, Issue 4, 2017. Pages: 155-166
Published Online: 1 December 2017

The Cost-effectiveness of the Online MindSpot Clinic for the Treatment of Depression and Anxiety in Australia

Yu-Chen Lee,¹ Lan Gao,¹ Blake F Dear,² Nickolai Titov,² Cathrine Mihalopoulos¹*

¹Deakin University, Geelong, Australia. Deakin Health Economics, School of Health and Social Development, Burwood, Vic, Australia
²Department of Psychology, Building C3A, Macquarie University, Sydney, NSW, Australia

* Correspondence to: Cathrine Mihalopoulos, Deakin University, Geelong, Australia. Deakin Health Economics, School of Health and Social Development, 221 Burwood Hwy, Burwood, Vic, Australia 3125.
Tel: +61-3-9251 738
E-mail: cathy.mihalopoulos@deakin.edu.au

Source of Funding: The current study was funded by Macquarie University. During this project CM was funded by a NHMRC Early Career Research Grant (APP1035887). BFD is supported by a National Health and Medical Research Council Australian Public Health Fellowship.

Abstract

The MindSpot Clinic offers internet-delivered cognitive behaviour therapy (ICBT) for people with anxiety and depressive disorders in Australia. The efficacy of the service has been established but the cost-effectiveness has not. A one-year decision-tree economic model was developed to assess the cost-effectiveness of the MindSpot Clinic in comparison with routine/usual care for people with symptoms of depression or/and anxiety from the perspective of the Australian Department of Health. The health benefits in the economic model were defined as four health states (i.e. fully recovered, partially recovered, no improvement, and deteriorated). The probability of being in these different health states were derived using data from the Mindspot clinic and from the most recent Australian national survey of high prevalence disorders. The result of the base case analysis suggested, for people seeking treatment, MindSpot was cost-saving and achieved better health outcomes compared to routine/usual care. Sensitivity analysis further reaffirmed that MindSpot was either cost-saving or very cost-effective.

Background: The MindSpot Clinic (MindSpot) offers internet-delivered cognitive behavior therapy (iCBT) courses for people with anxiety and depressive disorders in Australia. The efficacy credentials of the courses offered at MindSpot are now well established but not the credentials of cost-effectiveness. The current study is aimed to evaluate the cost-effectiveness of the Wellbeing Course offered in MindSpot in comparison with the routine/usual care (defined as care in the absence of MindSpot) for people with symptoms of depression or/and anxiety from the perspective of Australian Department of Health.

Methods: An economic model using a one-year decision-tree framework was constructed. The four health states in the model included: fully recovered; partially recovered; no improvement; and deteriorated. The probabilities between the four health states in the model were derived from a series of individual client datasets and from the Australian National Survey of Mental Health and Wellbeing. The EuroQol Five Dimension -- Five Level was used to derive the utilities, and costs were expressed in 2014 Australian dollars ($). Sensitivity analyses were conducted to examine the robustness of results to key model parameters.

Results: In the base case analysis, for people seeking treatment, care offered at Mindspot cost less and achieved greater benefits compared to the comparator. By adopting MindSpot, an additional 505 of fully recovered and 223 of partially recovered clients can be achieved per annum compared to routine/usual care. The result of the sensitivity analyses indicated the result of the analysis were robust.

Conclusions: This study found that the iCBT treatments provided by MindSpot were highly cost-effective in comparison with current routine/usual care in the Australia setting. However, future research using a prospective matched comparator that comprehensively assesses all the respective costs is required to verify the current study findings.

Received 19 October 2016; accepted 1 August 2017