OBJECTIVES: Today, there is an unmet need to provide good practices on economic evaluation of Digital Therapeutics (DTx) such as cost effectiveness analyses and budget impact are under development.y. DTx interventions offer potential economic benefits, but important methodological shortcomings need to be addressed to reduce the uncertainties surrounding their widespread adoption. This study summarize and discuss the results of a systematic literature review including DTx beyond mobile devices.

METHODS: To search for relevant literature, we follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines. The databases we search include PubMed, Scopus, Embase, Web of Science, CINAHL (EBSCO), Business Source Ultimate (EBSCO), and the Cochrane Library. Additionally, we look for gray literature from government departments and agencies working on health. The search encompasses publications from 2000 to 2024. We focus on cost-benefit, cost-effectiveness, and cost-utility analyses. In order to identify the issues related to the key aspects of a reference case for economic evaluation, an analysis of the quality of reporting of the selected studies is performed using the CHEERS checklist.

RESULTS: This review includes 10 studies. DTx interventions are used for opioid drug disorders (3/10), hypertension (2/10), type 2 diabetes (1/10), home-based cardiac rehabilitation (2/10), and low back pain management (2/10). DTx implementations are mostly in the USA (50%), China (20%), Japan (10%), and Germany (20%). All studies show that DTx interventions are cost-effective.

CONCLUSIONS: Our systematic literature review shows that some DTx may be considered cost-effective. However, improvements in the methodology used for economic evaluations of DTx are needed. Further research to include patient preferences should contribute to improving economic evaluations.