• E Hedman, E Andersson, N Lindefors, G Andersson, C Rück, and B Ljótsson.
• Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. kire.hedman@ki.se
• Psychol Med. 2013 Feb 1; 43 (2): 363-74.

BackgroundSevere health anxiety is a common condition associated with functional disability, making it a costly disorder from a societal perspective. Internet-based cognitive behaviour therapy (ICBT) is a promising treatment but no previous study has assessed the cost-effectiveness or long-term outcome of ICBT for severe health anxiety. The aim of this study was to investigate the cost-effectiveness and 1-year treatment effects of ICBT for severe health anxiety.MethodCost-effectiveness and 1-year follow-up data were obtained from a randomized controlled trial (RCT) comparing ICBT (n = 40) to an attention control condition (CC, n = 41). The primary outcome measure was the Health Anxiety Inventory (HAI). A societal perspective was taken and incremental cost-effectiveness ratios (ICERs) were calculated using bootstrap sampling.ResultsThe main ICER was -£1244, indicating the societal economic gain for each additional case of remission when administering ICBT. Baseline to 1-year follow-up effect sizes on the primary outcome measure were large (d = 1.71-1.95).ConclusionsICBT is a cost-effective treatment for severe health anxiety that can produce substantial and enduring effects.

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