OBJECTIVES: Depressive disorders show a high prevalence and lead to substantial direct and indirect costs. In many countries the increasing demand for psychiatric and psychotherapeutic care often is not sufficiently supplied with the consequence of waiting lists and progression of the disease. Computer-based psychotherapy (CPT) of depressive disorders is discussed as a possible solution to close this gap. Scope of this analysis was to estimate the budget impact of a CPT scheme in Germany.

METHODS: The budget impact of CPT was estimated based on data derived from clinical studies and administrative sources for costs for the German healthcare system in 2015. For the base case scenario a CPT population of 9.2% of all patients with depressive disorder was assumed. The cost of CPT was calculated with €250 per patient. Several sensitivity analyses were performed e.g. for the type and the price of CPT and the frequency of inpatient care.

RESULTS: The base case analysis resulted in slightly reduced annual expected costs of €3,876 including CPT compared to €3,884 for standard ambulatory and inpatient care alone. The additional costs of CPT are overcompensated by the reduced costs for inpatient and outpatient care. Sensitivity analyses showed that the model is robust to variations in CPT price and the proportion of patients treated with CPT whereas it was sensitive to the frequency of inpatient treatment and the cost of inpatient and outpatient treatment.

CONCLUSIONS: Regardless of the proportion of patients treated with CPT and also the different costs of the programs, CPT itself appears to have relatively small impact on the overall costs of depressed patients. The highest potential of cost savings were reached within a stepped-care approach including CPT because this regime leads to a substantial reduction of high-cost inpatient treatments.