Abstract：
OBJECTIVE: To investigate the cost-effectiveness of cognitive behavioral therapy for insomnia (CBTI), with an additional focus on digital CBTI (dCBTI) in adults with insomnia.
METHODS: We searched eight electronic databases for economic evaluations of CBTI: PubMed, Scopus, Web of Science, psycINFO, Cochrane, Library, CINAHL, ProQuest, and National Health Service Economic Evaluation Database. Meta-analyses were performed to investigate the effects and costs between CBTI and control groups (no treatment, other treatments included hygiene education and treatment as usual). Subgroup analyses for dCBTI were conducted.
RESULTS: Twelve randomized controlled trial studies between 2004 and 2023 were included in our systematic review and meta-analyses. The incremental cost-utility ratios and incremental cost-effectiveness ratios showed that the CBTI and dCBTI groups were more cost-effective than controls, from healthcare perspective and societal perspective, respectively. Compared to controls, CBTI demonstrated significantly better efficacy within 12 months. Healthcare costs were significantly higher in the CBTI groups compared to the controls within 6 months but there was no difference at 12 months. Additionally, dCBTI was associated with significantly lower presenteeism costs compared to controls at 6 months.
CONCLUSIONS: Our findings suggest that CBTI is more cost-effective than other treatments or no treatment for adults with insomnia. It may bring more economic benefits in the long term, especially in long-lasting efficacy and cost reduction. In addition, dCBTI is one of the cost-effective options for insomnia.
UNASSIGNED: CRD42 022 383 440.
UNASSIGNED: www.crd.york.ac.uk/PROSPERO.
UNASSIGNED: Cost-effectiveness of cognitive behavioral therapy for insomnia (CBTI): a systematic review with meta-analysis.
METHODS: We searched eight electronic databases for economic evaluations of CBTI: PubMed, Scopus, Web of Science, psycINFO, Cochrane, Library, CINAHL, ProQuest, and National Health Service Economic Evaluation Database. Meta-analyses were performed to investigate the effects and costs between CBTI and control groups (no treatment, other treatments included hygiene education and treatment as usual). Subgroup analyses for dCBTI were conducted.
RESULTS: Twelve randomized controlled trial studies between 2004 and 2023 were included in our systematic review and meta-analyses. The incremental cost-utility ratios and incremental cost-effectiveness ratios showed that the CBTI and dCBTI groups were more cost-effective than controls, from healthcare perspective and societal perspective, respectively. Compared to controls, CBTI demonstrated significantly better efficacy within 12 months. Healthcare costs were significantly higher in the CBTI groups compared to the controls within 6 months but there was no difference at 12 months. Additionally, dCBTI was associated with significantly lower presenteeism costs compared to controls at 6 months.
CONCLUSIONS: Our findings suggest that CBTI is more cost-effective than other treatments or no treatment for adults with insomnia. It may bring more economic benefits in the long term, especially in long-lasting efficacy and cost reduction. In addition, dCBTI is one of the cost-effective options for insomnia.
UNASSIGNED: CRD42 022 383 440.
UNASSIGNED: www.crd.york.ac.uk/PROSPERO.
UNASSIGNED: Cost-effectiveness of cognitive behavioral therapy for insomnia (CBTI): a systematic review with meta-analysis.
摘要：
目的：探讨认知行为疗法治疗失眠的成本-效果,另一个重点是失眠成人的数字认知行为疗法（dCBTI）。
方法：我们搜索了八个电子数据库，以进行CBTI的经济评估：PubMed，Scopus,WebofScience,psycINFO,科克伦,图书馆,CINAHL,ProQuest和国家卫生服务经济评价数据库。进行荟萃分析以调查CBTI组和对照组之间的效果和成本（不治疗，其他治疗包括卫生教育和照常治疗)。进行dCBTI的亚组分析。
结果：2004年至2023年的12项随机对照试验研究被纳入我们的系统评价和荟萃分析。增量成本-效用比和增量成本-效果比表明CBTI和dCBTI组比对照组更具成本效益,从医疗保健的角度和社会的角度来看，分别。与对照组相比，CBTI在12个月内表现出明显更好的疗效。在6个月内，CBTI组的医疗费用明显高于对照组，但在12个月时没有差异。此外,在6个月时,与对照组相比,dCBTI与明显较低的出勤费用相关.
结论：我们的研究结果表明，对于成人失眠患者，CBTI比其他治疗或不治疗更具成本效益。从长远来看，它可能会带来更多的经济利益，尤其是在持久疗效和降低成本方面。此外,dCBTI是治疗失眠的高性价比选择之一。
方法：我们搜索了八个电子数据库，以进行CBTI的经济评估：PubMed，Scopus,WebofScience,psycINFO,科克伦,图书馆,CINAHL,ProQuest和国家卫生服务经济评价数据库。进行荟萃分析以调查CBTI组和对照组之间的效果和成本（不治疗，其他治疗包括卫生教育和照常治疗)。进行dCBTI的亚组分析。
结果：2004年至2023年的12项随机对照试验研究被纳入我们的系统评价和荟萃分析。增量成本-效用比和增量成本-效果比表明CBTI和dCBTI组比对照组更具成本效益,从医疗保健的角度和社会的角度来看，分别。与对照组相比，CBTI在12个月内表现出明显更好的疗效。在6个月内，CBTI组的医疗费用明显高于对照组，但在12个月时没有差异。此外,在6个月时,与对照组相比,dCBTI与明显较低的出勤费用相关.
结论：我们的研究结果表明，对于成人失眠患者，CBTI比其他治疗或不治疗更具成本效益。从长远来看，它可能会带来更多的经济利益，尤其是在持久疗效和降低成本方面。此外,dCBTI是治疗失眠的高性价比选择之一。
