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Cost-effectiveness and long-term effectiveness of Internet-based cognitive behaviour therapy for severe health anxiety

  • E. Hedman (a1) (a2), E. Andersson (a3), N. Lindefors (a3), G. Andersson (a3) (a4), C. Rück (a3) and B. Ljótsson (a1)...

Severe health anxiety is a common condition associated with functional disability, making it a costly disorder from a societal perspective. Internet-based cognitive behaviour therapy (ICBT) is a promising treatment but no previous study has assessed the cost-effectiveness or long-term outcome of ICBT for severe health anxiety. The aim of this study was to investigate the cost-effectiveness and 1-year treatment effects of ICBT for severe health anxiety.


Cost-effectiveness and 1-year follow-up data were obtained from a randomized controlled trial (RCT) comparing ICBT (n = 40) to an attention control condition (CC, n = 41). The primary outcome measure was the Health Anxiety Inventory (HAI). A societal perspective was taken and incremental cost-effectiveness ratios (ICERs) were calculated using bootstrap sampling.


The main ICER was −£1244, indicating the societal economic gain for each additional case of remission when administering ICBT. Baseline to 1-year follow-up effect sizes on the primary outcome measure were large (d = 1.71–1.95).


ICBT is a cost-effective treatment for severe health anxiety that can produce substantial and enduring effects.

Corresponding author
*Address for correspondence: E. Hedman, Ph.D., Karolinska Institutet, Department of Clinical Neuroscience, SE-171 77 Stockholm, Sweden. (Email:
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