{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:59:39Z","timestamp":1782842379662,"version":"3.54.5"},"reference-count":72,"publisher":"JMIR Publications Inc.","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"\n Background<\/jats:title>\n The evidence base for internet-based cognitive behavioral therapy for insomnia (iCBT-I) is firm; however, little is known about iCBT-I\u2019s health-economic effects.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to evaluate the cost-effectiveness and cost\u2013utility of iCBT-I in reducing insomnia among schoolteachers.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Schoolteachers (N=128) with clinically significant insomnia symptoms and work-related rumination were randomized to guided iCBT-I or a wait list control group, both with unrestricted access to treatment as usual. Health care use, patient and family expenditures, and productivity losses were self-assessed and used for costing from a societal and a public health care perspective. Costs were related to symptom-free status (score <8 on the insomnia severity index) and quality-adjusted life years (QALYs) gained. Sampling error was handled using nonparametric bootstrapping.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Statistically significant differences favoring the intervention group were found for both health outcomes (symptom-free status yes or no: \u03b2=.30; 95% CI 0.16-0.43; QALYs: \u03b2=.019, 95% CI 0.01-0.03). From a societal perspective, iCBT-I had a 94% probability of dominating the wait list control for both health outcomes. From a public health care perspective, iCBT-I was more effective but also more expensive than the wait list control, resulting in an incremental cost-effectiveness ratio of \u20ac650 per symptom-free individual. In terms of QALYs, the incremental cost-effectiveness ratio was \u20ac11,285. At a willingness-to-pay threshold of \u20ac20,000 per QALY gained, the intervention\u2019s probability of being cost-effective was 89%.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Our trial indicates that iCBT could be considered as a good value-for-money intervention for insomnia.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n German Clinical Trial Registry: DRKS00004700; https:\/\/tinyurl.com\/2nnk57jm<\/jats:p>\n <\/jats:sec>\n \n International Registered Report Identifier (IRRID)<\/jats:title>\n RR2-10.1186\/1745-6215-14-169<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/25609","type":"journal-article","created":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T10:31:33Z","timestamp":1621852293000},"page":"e25609","source":"Crossref","is-referenced-by-count":19,"title":["Guided Internet-Based Cognitive Behavioral Therapy for Insomnia: Health-Economic Evaluation From the Societal and Public Health Care Perspective Alongside a Randomized Controlled 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