Is There Sufficient Economic Evidence for Reimbursing Behavioral Interventions? A Targeted Literature Review
Author(s)
Katarzyna Kolasa, PhD1, Andrew Kwist, MPH2, Fleur Levrat Guillen, PharmD3, Michael Vallis, PhD4.
1Center for Digital Health, Kozminski University, Warsaw, Poland, 2ABBOTT, San Francisco, CA, USA, 3Abbott diabetes care, London, United Kingdom, 4Dalhousie University, Halifax, NS, Canada.
1Center for Digital Health, Kozminski University, Warsaw, Poland, 2ABBOTT, San Francisco, CA, USA, 3Abbott diabetes care, London, United Kingdom, 4Dalhousie University, Halifax, NS, Canada.
OBJECTIVES: Healthcare reimbursement frameworks have traditionally focused on medicines and medical devices, often overlooking the preventive gains derived from behavior change. This study aimed to assess the availability of economic evidence supporting behavioral interventions in improving health outcomes and reducing disease risk.
METHODS: A targeted literature review (TLR) was conducted following PRISMA guidelines. Full-text articles were retrieved on June 10, 2025, using PubMed and Google Scholar. The search focused on studies published within the last five years that reported cost-effectiveness or other economic outcomes of behavioural interventions. Only systematic literature reviews (SLRs) including studies presenting quantitative economic results were included
RESULTS: Of the 95 records identified, 26 SLRs met the inclusion criteria, with 16 reporting economic data across more than 300 publications. These studies covered mental health, neurodevelopmental disorders, reproductive health and chronic diseases such as obesity and diabetes. Outcomes measured included QALYs, life years saved, BMI changes, work productivity and symptom improvement. Six of the 16 SLRs (24% of all studies) focused on digital health interventions (DHIs), including web-based CBT, telehealth, SMS reminders, mobile apps, and digital coaching. Of the above 300 studies, less than 15% reported ICERs. Against standard of care, the lowest ICER was £119 per QALY for web-based CBT for depression, while the highest was £179,799 per QALY for behavioural therapy targeting autism.
CONCLUSIONS: Although interest in behavioral interventions is growing, the available economic evidence remains limited and fragmented. A promising direction may be to establish reimbursement framework that explicitly links behavioral change to clinical outcomes. This approach is exemplified by continuous glucose monitoring (CGM) in diabetes care, where sustained self-management behaviors have led to measurable clinical improvements that, in turn, translate into meaningful economic value. Strengthening such connections can enhance the justification for reimbursement and support broader integration of behavioural interventions into standard healthcare practice.
METHODS: A targeted literature review (TLR) was conducted following PRISMA guidelines. Full-text articles were retrieved on June 10, 2025, using PubMed and Google Scholar. The search focused on studies published within the last five years that reported cost-effectiveness or other economic outcomes of behavioural interventions. Only systematic literature reviews (SLRs) including studies presenting quantitative economic results were included
RESULTS: Of the 95 records identified, 26 SLRs met the inclusion criteria, with 16 reporting economic data across more than 300 publications. These studies covered mental health, neurodevelopmental disorders, reproductive health and chronic diseases such as obesity and diabetes. Outcomes measured included QALYs, life years saved, BMI changes, work productivity and symptom improvement. Six of the 16 SLRs (24% of all studies) focused on digital health interventions (DHIs), including web-based CBT, telehealth, SMS reminders, mobile apps, and digital coaching. Of the above 300 studies, less than 15% reported ICERs. Against standard of care, the lowest ICER was £119 per QALY for web-based CBT for depression, while the highest was £179,799 per QALY for behavioural therapy targeting autism.
CONCLUSIONS: Although interest in behavioral interventions is growing, the available economic evidence remains limited and fragmented. A promising direction may be to establish reimbursement framework that explicitly links behavioral change to clinical outcomes. This approach is exemplified by continuous glucose monitoring (CGM) in diabetes care, where sustained self-management behaviors have led to measurable clinical improvements that, in turn, translate into meaningful economic value. Strengthening such connections can enhance the justification for reimbursement and support broader integration of behavioural interventions into standard healthcare practice.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HSD66
Topic
Health Service Delivery & Process of Care, Health Technology Assessment, Patient-Centered Research
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), Mental Health (including addition), No Additional Disease & Conditions/Specialized Treatment Areas