Abstract
The aim was to assess the changes in costs and economic impact of depression-related absenteeism in private company after use of internet-delivered cognitive behavioural therapy (iCBT) and gather preliminary data from Real World Data (RWD) economic model. Depression cost review was conduct through local RWD ( Paraná State- LATAM ). Economic, observational studies of certificates managing delivered in the 12-month period (December 2017 to 2018), related to ICD 10 DEPRESSION were included for comparisons . They were divided into sectors A, B and C, by salary and certificates number. Mean costs before introduction of iCBT were directly compared with the mean costs after, if incorporate. The certificates were 2562 / 140.447. Sector A had prevalence of 80.8% (2072), with an average leave 3.6 days/ year. B Sector 113/2562 certificates, 4.4% , 6.16 days / year. C Sector, 93 certificates, 3.6%, 6.78 days leave /year / each employee. 1860 certificates, 72.5%, were 3 days or less. Long certificates , 10 days or more 14.5% of total, 368 certificates. Considering salary analyzed and absenteeism, the loss account 620.000,00 Brazilian reals (R$) in sector A, R$ 162.000,00 in sector B and 84.000,00 R$ in sector C. It means 866.000 R$ ( = 250.000 USD ) / YEAR of lost work days . From literature , comparisons from eight studies (N = 2402) demonstrated the effectiveness of IDCBT for depressive, medium effect (g = 0.54, 95% CI: 0.39-0.69). So applying these finding as model to our RWD , the results are in the worst scenario a saving of USD 97.500 and USD 172.500 in the best scenario. Following iCBT recommendation, our study showed that is clear the decrease depression-related costs comparing local RWD before and after implementation of new technology. Studies are need due to price threshold value and the value of patient health.
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