OBJECTIVES: Digital health interventions (DHIs) include a range of technologies from telephone to telemonitoring. Research has suggested that these devices help in prevention and improved clinical outcomes in chronic diseases. However, a holistic understanding of the evidence of their cost-effectiveness remains unclear. This study aimed to understand the cost-effectiveness of DHIs in chronic diseases.

METHODS: A meta-review was conducted in PubMed to collect the systematic literature reviews (SLRs) published on the cost-effectiveness of DHIs in chronic diseases, including cardiovascular diseases [CVDs] (i.e., heart failure, myocardial infarction, hypertension, stroke), diabetes and obesity. No restriction on years was applied. Only full-text papers published in English were included.

RESULTS: Of the 118 studies retrieved from searches, 15 SLRs were eligible and included for analysis. Ten of 15 SLRs (67%) were published in 2020 and onwards. These SLRs were for CVDs (n=7; 47%), diabetes (n=6; 40%), obesity (n=1; 7%), and mixed of three diseases (n=1; 7%). Of the several DHIs across SLRs, the most common were telemonitoring (n=6; 40%), telemedicine (n=4; 27%), and tele-consultation (n=2; 13%). The number of studies included in SLRs varied (5–20 CVDs; 2–37 diabetes; 2–20 obesity). In six SLRs reporting clear information on modelling approaches used in studies, Markov model (10%-64%) or decision-tree (15%-37%) were common. In six SLRs of CVDs most studies were either cost-effective (7%–78%) or cost-saving (10%–80%), whereas in two SLRs, most studies reported not to be cost-effective. Similarly, for diabetes, 9%–89% studies were cost-effective and 36%–100% were cost-savings. For obesity, 30%–50% studies were cost-effective or cost-savings.

CONCLUSIONS: The use of DHIs concurrently with standard care appears to be cost-effective or cost-savings in the management of chronic diseases such as CVDs, diabetes, and obesity. The long-term use of these devices should be encouraged so that the burden on healthcare systems can be alleviated.