OBJECTIVES: Depressive disorders show a high prevalence and lead to substantial direct and indirect costs. In many countries there is an increasing demand for psychotherapeutic care combined with a lack of sufficient supply. Consequences are waiting lists and progression of the disease. Computer-assisted psychotherapy (CAPT) of depressive disorders is discussed as a possible solution to close this gap. Scope of this analysis was to estimate the costs and saving of the use of a CAPT scheme in Germany.

METHODS: The calculations were based on data derived from clinical studies and administrative sources for costs for the German healthcare system in 2016. For the base case scenario a CAPT population of 9.2% of all patients with depressive disorder was assumed. The cost of CAPT was calculated with €250 per patient. Several sensitivity analyses were performed e.g. for the type and the price of CAPT and the frequency of inpatient care.

RESULTS: The base case analysis resulted in slightly reduced annual costs of €3,960 including CAPT compared to €3,994 for standard ambulatory and inpatient care alone. The additional costs of CAPT are compensated by the reduced costs for inpatient and outpatient care. Sensitivity analyses showed that the model is robust to variations in CAPT price and the proportion of patients treated, 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 CAPT and also the different costs of the programs, CAPT itself seems to have relatively small impact on the overall costs of depressed patients. The highest potential of cost savings were reached with a stepped-care approach including CAPT because this combined regime leads to a higher reduction of high-cost inpatient treatments. Additional studies on the medical benefits and the costs of that complex intervention are required.