Cost Benefit Analysis of Cognitive Behavioral Therapy versus Light Therapy for Seasonal Affective Disorder

A cost-benefit analysis within a major clinical trial compared two therapeutic modalities, CBT and LT, for the treatment of SAD. Resources devoted to treatment by both providers and patients (i.e., costs), and changes in productivity and health care utilization by patients (i.e., outcomes), were monetized and assessed. Pretreatment sample size equaled 145 patients (CBT = 76, LT = 69); 135 at one-year follow-up (CBT = 72, LT = 63). From the perspective of treatment providers, total cost per patient to conduct the 6-week treatment averaged $229.35 for CBT and $121.06 for LT. From the perspective of the patient, cost averaged $663.36 for CBT and $898.30 for LT, per patient. After initial 6-week treatment was completed, additional CBT cost was nil, while LT continued to require both provider and patients' time. Patients in the CBT condition used fewer emergency room services by one-year follow-up (U (134) = 1,928, p = .033) and the total ER cost was less (U (134) = 1,925, p = .031) than those treated with LT. Net benefit was significantly less than zero from the patient perspective (CBT = -$518.16, p = .013; LT = -$607.90, p = .007) and from the combined patient and provider perspective (CBT = -$747.51, p = .003; LT = -$728.96, p = .003). However, when comparing the net benefit of CBT versus LT, from both perspectives, differences were not significant. Significant differences may become apparent as LT users continue to require treatment during the second and subsequent winters following initial treatment while those treated with CBT may not.