Digital health technologies: a systematic review of their cost-effectiveness

Abstract

Abstract Background Digital health interventions have a potential to improve safety, efficacy and quality of care, reducing waste in healthcare costs. Despite premises, the evidence regarding cost and effectiveness of digital tools in health is scarce and limited. Objectives: The aim of this systematic review is to summarize the evidence on cost-effectiveness of digital health interventions and to assess whether the studies meet the established quality criteria. Methods We queried PubMed, Scopus and Web of Science databases for articles in English published from 1 January 2016 to 31 December 2020 that performed economic evaluations of digital health technologies. The methodological rigorousness of studies was assessed with a well-established checklist (CHEERS). The incremental cost-effectiveness ratio (ICER)was calculated when the reviewed study reported related data but did not express the ICER. Results Searches identified 1476 results, 552 of which were selected for abstract and 35 were included in this review. The studies were heterogeneous by country, type of eHealth intervention, method of implementation, and reporting perspectives. The qualitative analysis identified the economic and effectiveness evaluation of seven different types of interventions: fourteen studies on a new telemedicine service; five on telecounseling; five on teletherapy; two on telemonitoring; five on new mobile applications; two on m-health programs; one on digital platforms and one on electronic health records. Conclusions Findings on cost-effectiveness of digital interventions showed a growing body of evidence and suggested a generally favorable effect in terms of costs and health outcomes. However, due to the heterogeneity across study methods, the comparison between interventions still remains difficult. Further research based on a standardized approach is needed in order to methodically analyze incremental cost-effectiveness ratios, costs, and health benefits. Key messages Digital interventions suggested a favorable effect in terms of costs and health outcomes. Digital health interventions have a potential to improve safety, efficacy and quality of care.