OBJECTIVES: Irritable bowel syndrome (IBS) is the most frequently reported functional abdominal pain disorder in the pediatric population, impacting about 8% of children and adolescents. The existing evidence supports the effectiveness of exposure-based internet-delivered cognitive behavior therapy (i-CBT) delivered to pediatric populations, but there is yet no evidence on its cost effectiveness. This study assessed whether exposure-based i-CBT is cost effective compared to a waitlist control, from a limited societal perspective.

METHODS: This cost effectiveness study was based on data from a randomized controlled trial examining the efficacy of exposure-based i-CBT delivered to adolescents with IBS, compared with a waitlist control. Eligible participants were adolescents aged 13 to 17 years old with IBS. Cost per point improvement on the PedsQL scale was used as measure of effectiveness. Resource use was measured prospectively using the TIC-P health service receipt inventory. Multiple imputation was used to handle missing data.

RESULTS: Adolescents in the i-CBT group showed an average improvement of 5.647 points on the PedsQL scale compared to the waitlist, and an additional cost of $288.60. The incremental cost effectiveness ratio was US$119.74 per one point improvement on the PedsQL scale.

CONCLUSIONS: The results of the base-case cost effectiveness analyses demonstrated that i-CBT resulted in higher costs but also a significant improvement in health-related quality of life, compared with the waitlist control. i-CBT has the potential of being cost effective but given the absence of a willingness to pay value for a one point improvement on the PedsQL scale, fuller economic evaluations are needed to provide stronger evidence for decision-making.