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Developing a Program Costs Checklist of Digital Health Interventions: A Scoping Review and Empirical Case Study

Author

Listed:
  • Zareen Abbas Khan

    (Trondheim University Hospital
    Norwegian University of Science and Technology)

  • Kristian Kidholm

    (University of Southern Denmark)

  • Sindre Andre Pedersen

    (Norwegian University of Science and Technology)

  • Silje Marie Haga

    (Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway)

  • Filip Drozd

    (Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway)

  • Thea Sundrehagen

    (Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway)

  • Ellen Olavesen

    (Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway)

  • Vidar Halsteinli

    (Trondheim University Hospital)

Abstract

Introduction The rate of development and complexity of digital health interventions (DHIs) in recent years has to some extent outpaced the methodological development in economic evaluation and costing. Particularly, the choice of cost components included in intervention or program costs of DHIs have received scant attention. The aim of this study was to build a literature-informed checklist of program cost components of DHIs. The checklist was next tested by applying it to an empirical case, Mamma Mia, a DHI developed to prevent perinatal depression. Method A scoping review with a structured literature search identified peer-reviewed literature from 2010 to 2022 that offers guidance on program costs of DHIs. Relevant guidance was summarized and extracted elements were organized into categories of main cost components and their associated activities following the standard three-step approach, that is, activities, resource use and unit costs. Results Of the 3448 records reviewed, 12 studies met the criteria for data extraction. The main cost categories identified were development, research, maintenance, implementation and health personnel involvement (HPI). Costs are largely considered to be context-specific, may decrease as the DHI matures and vary with number of users. The five categories and their associated activities constitute the checklist. This was applied to estimate program costs per user for Mamma Mia Self-Guided and Blended, the latter including additional guidance from public health nurses during standard maternal check-ups. Excluding research, the program cost per mother was more than double for Blended compared with Self-Guided (€140.5 versus €56.6, 2022 Euros) due to increased implementation and HPI costs. Including research increased the program costs to €190.8 and €106.9, respectively. One-way sensitivity analyses showed sensitivity to changes in number of users, lifespan of the app, salaries and license fee. Conclusion The checklist can help increase transparency of cost calculation and improve future comparison across studies.

Suggested Citation

  • Zareen Abbas Khan & Kristian Kidholm & Sindre Andre Pedersen & Silje Marie Haga & Filip Drozd & Thea Sundrehagen & Ellen Olavesen & Vidar Halsteinli, 2024. "Developing a Program Costs Checklist of Digital Health Interventions: A Scoping Review and Empirical Case Study," PharmacoEconomics, Springer, vol. 42(6), pages 663-678, June.
    • Handle: RePEc:spr:pharme:v:42:y:2024:i:6:d:10.1007_s40273-024-01366-y
    DOI: 10.1007/s40273-024-01366-y
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    References listed on IDEAS

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    1. Wilkinson,Thomas David & Wang,Mengxiao & Friedman,Jed & Prestidge,Marelize, 2023. "A Framework for the Economic Evaluation of Digital Health Interventions," Policy Research Working Paper Series 10407, The World Bank.
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    3. Valerio Benedetto & Luís Filipe & Catherine Harris & Joseph Spencer & Carmel Hickson & Andrew Clegg, 2023. "Analytical Frameworks and Outcome Measures in Economic Evaluations of Digital Health Interventions: A Methodological Systematic Review," Medical Decision Making, , vol. 43(1), pages 125-138, January.
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    5. Kristian Kidholm & Mie Borch Dahl Kristensen, 2018. "Correction to: A Scoping Review of Economic Evaluations Alongside Randomised Controlled Trials of Home Monitoring in Chronic Disease Management," Applied Health Economics and Health Policy, Springer, vol. 16(2), pages 273-273, April.
    6. Karolina Socha-Dietrich, 2021. "Empowering the health workforce to make the most of the digital revolution," OECD Health Working Papers 129, OECD Publishing.
    7. Kristian Kidholm & Mie Borch Dahl Kristensen, 2018. "A Scoping Review of Economic Evaluations Alongside Randomised Controlled Trials of Home Monitoring in Chronic Disease Management," Applied Health Economics and Health Policy, Springer, vol. 16(2), pages 167-176, April.
    8. Dina Jankovic & Laura Bojke & David Marshall & Pedro Saramago Goncalves & Rachel Churchill & Hollie Melton & Sally Brabyn & Lina Gega, 2021. "Systematic Review and Critique of Methods for Economic Evaluation of Digital Mental Health Interventions," Applied Health Economics and Health Policy, Springer, vol. 19(1), pages 17-27, January.
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