# Cost Savings Associated With Fully Automated Digital Cognitive Behavioral Therapy for Insomnia Disorder (SleepioRx): A Matched Control Study of US Patients

## TL;DR

A study found that using a fully automated digital therapy for insomnia saved healthcare costs by 42% compared to standard care.

## Contribution

The study provides new evidence on cost savings from digital CBT-I in a large US patient population.

## Key findings

- Digital CBT-I saved an average of $2083 per person annually compared to standard care.
- The cost savings were statistically significant and equated to a 42% reduction.
- Digital CBT-I improves access to treatment while reducing healthcare costs.

## Abstract

Insomnia affects up to one-third of US adults and is a significant health challenge with an estimated economic burden of up to $100 billion annually. Cognitive behavioral therapy (CBT) for insomnia (CBT-I) is the recommended first-line treatment, but access is limited due to a shortage of trained therapists. Digital CBT-I offers an effective alternative that may enhance accessibility and reduce higher healthcare costs associated with insomnia.

To evaluate the US healthcare cost-savings of digital CBT-I compared with standard-of-care control.

A retrospective difference-in-differences analysis compared 1-year preinitiation and post-initiation healthcare costs for 11 027 individuals receiving SleepioRx (FDA-cleared digital CBT treatment for insomnia disorder) compared with 1:1 exact matched controls with insomnia receiving standard care (n = 10 770). Commercial and Medicare claims were adjusted for comorbidities, index year, and baseline utilization.

Digital CBT-I was associated with statistically significant mean annual total cost savings of 2083(951508-$2657, P < .001) per person, equating to a 42% reduction in costs with SleepioRx relative to matched controls who received standard of care (medications for insomnia).

Digital CBT-I was associated with substantial cost savings for payers. The integration of guideline-concordant treatment through digital delivery into standard care pathways offers a promising strategy to address the clinical and economic challenges of insomnia, supporting more efficient resource allocation.

Findings suggest that implementing digital CBT-I at scale may lead to decreased costs for healthcare payers, relative to the current standard of care, while improving access to effective insomnia treatment.