The cost-effectiveness of delivering an e-health intervention, MoodGYM, to prevent anxiety disorders among Australian adolescents: A model-based economic evaluation

Abstract

BackgroundAnxiety disorders are a common mental health diagnosis among adolescents and can adversely impact health, education and social wellbeing. This study evaluated the cost-effectiveness of delivering an online e-health intervention, MoodGYM, to prevent anxiety among adolescent students. MethodA Markov model was developed to evaluate the population cost-effectiveness of delivering MoodGYM to prevent anxiety disorders among Australian students aged 11-17 years, relative to ‘no intervention’. The study conducted: (1) a cost-utility analysis to estimate an incremental cost-effectiveness ratio (ICER) expressed as a cost per quality-adjusted life year (QALYs); and (2) a return-on-investment (ROI) analysis to estimate a ROI ratio that divides total cost savings (due to health care cost savings and productivity gains) by total intervention costs. Costs, expressed in 2016 Australian dollars, and health impacts were modelled over a 10-year time horizon starting in 2016 and discounted at 3% per year. Uncertainty and sensitivity analyses were conducted to test the robustness of input parameters/assumptions. ResultsBoth analyses indicated that MoodGYM represents good value-for-money. The cost-utility analysis produced a dominant ICER (95% uncertainty interval [UI]: dominant–dominant), indicating the intervention produced positive health benefits and net cost savings. The ROI analysis produced an ROI ratio of 3.06 (95% UI: 1.33–7.85), denoting a return of A$3.06 for every A$1 invested. ConclusionDelivering MoodGYM to Australian students aged 11-17 years can produce net cost savings and should be considered for scale up across schools in Australia. Access to the intervention may be hindered by poor internet connectivity in rural/remote regions.