Cost-effectiveness of an internet-based booster program for patients with obsessive–compulsive disorder: Results from a randomized controlled trial

• Many OCD patients relapse after reciveing CBT.
• Booster programs have been showing some promising results to reduce relapse but there are no health economical evaluations of these interventions. This study therefore set out to investigate the cost-effectiveness of an internet-based booster program.
• Results showed that the price of one avoided relapse was estimated to $1066–1489.
• Internet-based booster programs are probably cost-effective.

Cognitive behavior therapy (CBT) is an effective treatment for OCD when delivered face-to-face, in group-format and also via the internet. However, despite overall large effect sizes, a considerable amount of the patients relapse. One intervention that has the potential to reduce these relapse rates is booster programs, but if booster program is a cost-effective method of preventing relapse is still unknown. We used health economical data from a recent randomized controlled trial, where patients who had undergone an internet-based CBT were randomly allocated to receive an additional booster program. Assessment points were 4-, 7-, 12- and 24-month. Health economical data were primarily analyzed using a societal perspective. Results showed that the booster program was effective in preventing relapse, and the cost of one avoided relapse was estimated to $1066–1489. Cost-effectiveness acceptability curves showed that the booster program had a 90% probability of being cost-effective given a willingness to pay of $1000–1050 the first year, but this figure grew considerably after two years ($2500–5500). We conclude that internet-based booster programs are probably a cost-effective alternative within one-year time frame and that more treatment may be needed to maintain adequate cost-effectiveness up to two years.