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The Cost-Utility of a Workplace Mental Health Program for Employees with Common Mental Disorders (FRIAA Project)

Mulfinger N, Waldmann T, Herold R, Weber J, Heming M, Feiißt M, Kröger C, Hansmann M, Gündel H, Hander NR, Rothermund-Nassir E, Kilian R (2026)

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Publication Type: Journal article

Publication year: 2026

Journal

Book Volume: 29

Pages Range: 23-35

Journal Issue: 1

Abstract

Background: Common mental disorders (CMDs) are a leading cause of sickness absence and early retirement due to health problems. Early identification and treatment of CMDs may have a positive impact on prognosis and associated economic costs, including healthcare expenditure, lost productivity, and the societal burden. The effectiveness of workplace psychotherapeutic interventions has been studied, but information on cost-effectiveness in this population is lacking. Aims of the Study: This study evaluates the cost-effectiveness of the FRIAA intervention for employees with CMDs compared to care as usual (CAU), with the aim of reducing sickness absence and preventing early retirement. Methods: We used data from a multicenter randomized controlled trial involving 549 employees with mental health problems in different companies located near five study centers in Germany, who provided data at nine- and 15-month follow-up. A total of 545 records were available for the economic evaluation (EE). 278 participants were assigned to the intervention group (FRIAA), and 267 participants were assigned to the CAU condition. On average, intervention participants received eight intervention sessions. The use of health and social care services was assessed using the Client Sociodemographic and Service Receipt Inventory (CSSRI) at nine- and 15-month follow-up. Data were transformed to a 12-month reference period. Quality of life was measured using the EQ-5D-5L questionnaire. Cost-utility analysis was performed by calculating additional costs per one additional quality adjusted life year (QALY). Results: The annual cost difference between FRIAA and CAU was € 3,484.29 (95 % confidence interval [CI] € 1,033.91 to € 5,934.67), which was significant (p = 0.005). We estimated the average QALY in the CAU group to be 0.768 (SD = 0.200) and in the FRIAA-group to be 0.789 (SD = 0.192). The difference in QALY between FRIAA and CAU was 0.021 (95 % CI -0.013 to 0.055), which was not significant (p = 0.203). The incremental cost-utility ratio (ICUR) showed that the intervention was associated with costs of € 165,918.57 for one additional year of full health. Discussion: As far as we know, this was the first EE of a psychotherapeutic consultation at work called FRIAA. Compared to CAU, FRIAA did not result in improved quality of life in terms of QALYs, nor favourable cost-utility for FRIAA compared with CAU. The FRIAA intervention cannot be considered cost-effective compared to CAU. Implications: This EE found that differences in costs were significant (with higher costs in the FRIAA group), while no statistically significant differences in QALYs were observed between the study groups. In addition, the cost-utility for FRIAA compared with CAU was not favourable. Participants with CMDs may need more time to integrate what they discuss in psychotherapy sessions into their daily lives before they can improve their personal quality of life and thus show long-term changes in sick days. Longer follow-up periods may be needed in future studies.

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APA:

Mulfinger, N., Waldmann, T., Herold, R., Weber, J., Heming, M., Feiißt, M.,... Kilian, R. (2026). The Cost-Utility of a Workplace Mental Health Program for Employees with Common Mental Disorders (FRIAA Project). Journal of Mental Health Policy and Economics, 29(1), 23-35.

MLA:

Mulfinger, Nadine, et al. "The Cost-Utility of a Workplace Mental Health Program for Employees with Common Mental Disorders (FRIAA Project)." Journal of Mental Health Policy and Economics 29.1 (2026): 23-35.

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