Open Access Highly Accessed Open Badges Research article

Cost-effectiveness of internet-based cognitive behavior therapy for irritable bowel syndrome: results from a randomized controlled trial

Erik Andersson1*, Brjánn Ljótsson1, Filip Smit23, Björn Paxling234, Erik Hedman1, Nils Lindefors1, Gerhard Andersson14 and Christian Rück1

Author affiliations

1 Department of Clinical Neuroscience, Stockholm Center for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden

2 Department of Epidemiology and Biostatistics, EMGO Institute for Health and Health Care Research, VU University Medical Centre, Amsterdam, Netherlands

3 Centre of Prevention and Early Intervention, Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, Netherlands

4 Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Sweden

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Citation and License

BMC Public Health 2011, 11:215  doi:10.1186/1471-2458-11-215

Published: 7 April 2011



Irritable Bowel Syndrome (IBS) is highly prevalent and is associated with a substantial economic burden. Cognitive behavior therapy (CBT) has been shown to be effective in treating IBS. The aim of this study was to evaluate the cost-effectiveness of a new treatment alternative, internet-delivered CBT based on exposure and mindfulness exercises.


Participants (N = 85) with IBS were recruited through self-referral and were assessed via a telephone interview and self-report measures on the internet. Participants were randomized to internet-delivered CBT or to a discussion forum. Economic data was assessed at pre-, post- and at 3-month and 1 year follow-up.


Significant cost reductions were found for the treatment group at $16,806 per successfully treated case. The cost reductions were mainly driven by reduced work loss in the treatment group. Results were sustained at 3-month and 1 year follow-up.


Internet-delivered CBT appears to generate health gains in IBS treatment and is associated with cost-savings from a societal perspective.

Cognitive behavior therapy; internet; IBS; cost-effectiveness analysis