Romero-Sanchiz, PabloNogueira-Arjona, RaquelGarcía-Ruiz, AntonioLuciano, Juan VGarcía Campayo, JavierGili, MargalidaBotella, CristinaBaños, RosaCastro, AdoraciónLópez-Del-Hoyo, YolandaPérez Ara, Mª ÁngelesModrego-Alarcón, MartaMayoral Cleríes, Fermín2017-05-262017-05-262017-02Romero-Sanchiz P, Nogueira-Arjona R, García-Ruiz A, Luciano JV, García Campayo J, Gili M, et al. Economic evaluation of a guided and unguided internet-based CBT intervention for major depression: Results from a multi-center, three-armed randomized controlled trial conducted in primary care. PLoS ONE. 2017; 12(2): e0172741.http://hdl.handle.net/10668/2677TRIAL REGISTRATION: clinicaltrials.gov NCT01611818.Depression is one of the most common mental disorders and will become one of the leading causes of disability in the world. Internet-based CBT programs for depression have been classified as "well established" following the American Psychological Association criteria for empirically supported treatments. The aim of this study is to analyze the cost effectiveness at 12-month follow-up of the Internet-based CBT program "Smiling is fun" with (LITG) and without psychotherapist support (TSG) compared to usual care. The perspective used in our analysis is societal. A sample of 296 depressed patients (mean age of 43.04 years; 76% female; BDI-II mean score = 22.37) from primary care services in four Spanish regions were randomized in the RCT. The complete case and intention-to-treat (ITT) perspectives were used for the analyses. The results demonstrated that both Internet-based CBT interventions exhibited cost utility and cost effectiveness compared with a control group. The complete case analyses revealed an incremental cost-effectiveness ratio (ICER) of €-169.50 and an incremental cost-utility ratio (ICUR) of €-11389.66 for the TSG group and an ICER of €-104.63 and an ICUR of €-6380.86 for the LITG group. The ITT analyses found an ICER of €-98.37 and an ICUR of €-5160.40 for the TSG group and an ICER of €-9.91 and an ICUR of €496.72 for the LITG group. In summary, the results of this study indicate that the two Internet-based CBT interventions are appropriate from both economic and clinical perspectives for depressed patients in the Spanish primary care system. These interventions not only help patients to improve clinically but also generate societal savings.enAdultoGrupos controlAnálisis costo-beneficioDepresiónTrastorno depresivoFemeninoEstudios de seguimientoHispanoamericanosHumanosAnálisis de intención de tratarInternetAtención primaria de saludPsicoterapiaSonrisaSociedades científicasMedical Subject Headings::Persons::Persons::Age Groups::AdultMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Methods::Research Design::Control GroupsMedical Subject Headings::Health Care::Health Care Economics and Organizations::Economics::Costs and Cost Analysis::Cost-Benefit AnalysisMedical Subject Headings::Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Behavioral Symptoms::DepressionMedical Subject Headings::Psychiatry and Psychology::Mental Disorders::Mood Disorders::Depressive DisorderMedical Subject Headings::Check Tags::FemaleMedical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Follow-Up StudiesMedical Subject Headings::Persons::Persons::Population Groups::Ethnic Groups::Hispanic AmericansMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Epidemiologic Study Characteristics as Topic::Clinical Trials as Topic::Controlled Clinical Trials as Topic::Randomized Controlled Trials as Topic::Intention to Treat AnalysisMedical Subject Headings::Information Science::Information Science::Computing Methodologies::Computer Systems::Computer Communication Networks::InternetMedical Subject Headings::Health Care::Health Services Administration::Patient Care Management::Comprehensive Health Care::Primary Health CareMedical Subject Headings::Psychiatry and Psychology::Behavioral Disciplines and Activities::PsychotherapyMedical Subject Headings::Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Communication::Nonverbal Communication::Facial Expression::SmilingMedical Subject Headings::Health Care::Health Care Economics and Organizations::Organizations::Societies::Societies, Scientificresearch article28241025open access10.1371/journal.pone.01727411932-6203PMC5328395