Table 3

Study outcome of the included economic evaluations on mental health interventions that were focused on prevention, treatment or return-to-work for (sick-listed) workers

Study Effectiveness/benefits CostsICER/ICUR/CBR/net costs or benefits/ROISensitivity or uncertainty analysis
Economic evaluation studies on mental health interventions aimed at prevention or treatment
 Lo Sasso et al25; USAIncremental benefits year 1: US$2100 per participating employee; year 2: US$5500Incremental costs year 1: US$735 per participating employee; year 2: US$353Net benefits year 1: US$30 per worker; year 2: US$257 per worker; ROI over 2 years: 302%Net benefits year 1 ranges between US$-69 and 130 per worker; year 2: between US$101 and US$494 per worker; ROI over 2 years: 20–566%
 Bittman et al26; USA46% improvement burnout and mood dimensions; reduction in turnover of 18%Intervention costs: US$1500 per year; average costs per turnover: US$8100Average cost savings of US$89100 for a single typical 100-bed facility; ‘ROI’: US$60 saved for every dollar investedNo sensitivity analyses
 Wang et al6; USACUA: incremental effectiveness: 0.02 QALYS (intervention 18.8 QALYs per person; usual care: 18.7 QALYs per person); CBA: savings of US$29800 per 1000 employeesCUA: incremental costs: US$39.9 per person (intervention US$3700; usual care US$3600); CBA: costs of US$26900 per 1000 employeesCUA: ICER US$20000 per QALY gained; CBA: net benefits of US$2900 per 1000 workersCUA: univariate sensitivity analyses: ICER most sensitive to treatment costs; probabilistic sensitivity analyses: 95% CI: US$9200 to US$49000; CBA: results most sensitive to treatment costs
 Vogt et al27; DenmarkMean RTW intervention and control group: 4 and 1 day. 32 workers recovered 1 day faster and 5 recovered 3 days faster: total 47 days. Total savings from increased work recovery: 47×US$ 958 (mean daily wage)=US$45026Intervention costs: US$268 per worker. For 47 workers (=N at baseline): US$12596Cost reduction per 47 workers: US$45026–US$12596=US$32430; ROI: 257%No sensitivity analyses
Economic evaluations on interventions aimed at RTW among sick-listed workers
 Van Oostrom et al28; The NetherlandsNo statistically significant differences between groups in QALYs and RTW subgroup of employees with intention to RTW: 62 days sick leave gainNo statistically significant differences between groupsICER: €627 per 1-day reduction in sick leave; ICUR: €1846001 per QALY; CBA: net costs of €2000; subgroup analysis: ICER: €10; ICUR: €124000; CBA: €6200Uncertainty analysis: ICER and ICUR not robust
 Brouwers et al29; The NetherlandsNo statistically significant difference between the groups on functional status, health status and sick leave durationNo statistically significant differences between groupsICER: €167 and €81 per improvement health score; ICUR: €4200 per QALY gained; CBA: net costs: €11 (95% CI −1800 to 1800)Univariate sensitivity analyses: results robust; uncertainty analyses: ICER not significant
 Leon et al30; USA5–52 non-cancer claimants RTW: savings of US$500000–US$5200000; 2–22 cancer claimants RTW: savings of US$200000–US$2200000Total costs between US$520000 and US$1300000 for non-cancer claimants and between US$418000 and US$1044000 for cancer claimantsNet benefits between US$-21300 and US$3897000 for non-cancer claimants and between US$-444400 and US$1156000 for cancer claimants; costs offset if 5–40% of non-cancer claimants would RTW or 9–75% of cancer claimants would RTWLarge ranges in estimations for different assumptions
 Rebergen et al31; The NetherlandsNo significant differences in days of sick leave and costs of loss of productivity; health utilisation costs: €2100 (SD €2000) in the intervention group and €2700 (SD €1600) in the control group; mean difference of €520 (95% CI €980 to €17)Intervention costs: intervention group: €552 (SD 280); control group: €486 (SD 277); difference €66 (€2–151)CEA: €736/day on sick leave; acceptability curve did not exceed the probability of being cost-effective of 50%; CBA: net benefit s of €3600Univariate sensitivity analyses: overall results remain similar (robust); uncertainty analyses: not robust
 Schene et al32; The NetherlandsNo statistically significant differences between groups in percentage of patients with major depression and work stress; mean number of days until work resumption intervention group: 207 days; control group: 299 days; RR=2.71 (95% CI 1.16 to 6.29)No statistically significant differences between groups in total healthcare costsNet benefits per person intervention group: US$15; control group: US$11; likelihood of being cost-effective is 76%Univariate sensitivity analyses; results are robust
 Uegaki et al33; The NetherlandsNo statistically significant differences in QALYs between groupsNo statistically significant differences in healthcare costs and productivity costsICER: €7400; for willingness-to-pay thresholds from €0 to €100000, the probability of being cost-effective is 0.58–0.90Univariate sensitivity analyses: ICERs ranged between €37900 and €46100 (not robust)
  • CBA, cost-benefit analysis; CBR, cost-benefit ratio; CE, cost-effectiveness; CEA, cost-effectiveness analysis; CUA, cost-utility analysis; ICER, incremental cost-effectiveness ratio; ICUR, incremental cost-utility ratio; QALY, quality adjusted life year; ROI, return on investment; RR, relative risk; ; RTW, return to work; .