Cost-effectiveness of an internet-based guided recovery training for better sleep and psychological detachment from work

Abstract

Background: Lost productivity due to insomnia in the working-population is a common and costly problem. This study aims to evaluate the cost-effectiveness, cost-utility and cost-benefit of an internet-based guided self-help intervention which aimed to improve recovery from work-related strain in teachers with sleeping problems and work-related rumination. Methods: School teachers (N = 128) with clinically significant insomnia symptoms and work-related rumination were randomized to guided internet-based guided self-help or a control-group, both with access to occupational care-as-usual. Economic data were collected at baseline and 6-month follow-up. We conducted a) a cost-effectiveness analysis with treatment response (Reliable Change [decline of 5.01 points] and Insomnia Severity Index < 8 at 6-month follow-up) as the outcome and b) a cost-benefit analysis and c) a cost-utility analyses with QALYS as outcome. Analyses were performed from both the societal (SP) and the employer’s perspective (EP). Statistical uncertainty was estimated using bootstrapping. Findings: Assuming intervention costs of €200 ($245), cost-effectiveness analyses from the EP showed that at a willingness-to-pay of €0 for each positive treatment response, there is a 87% probability that the intervention is more cost-effective than occupational care-as-usual alone. Cost-benefit analyses led to a net-benefit of €418 (95%CI:-593.03–1488.70) ($512) per participant in the first 6 months and a return-on-investment of 208% (95%CI:-296.52–744.35). Cost-utility analysis and detailed results from the SP will be presented. Conclusions: Providing Internet-based guided self-help can be good value for money for improving recovery from work-related strain in teachers with sleeping problems and work-related rumination.