New article on effective methods to estimate the program costs of digital health interventions

Digital health interventions have grown rapidly in recent years but the methodological guidance on performing their economic evaluations has not kept pace. Particularly, there is no systematic guidance to estimate the program or intervention costs of digital technologies in healthcare. Zareen Abbas Khan at St. Olav’s Hospital is the lead author of the article now published in the journal Pharmacoeconomics ( “Developing a Program Costs Checklist of Digital Health Interventions: A Scoping Review and Empirical Case Study.” The article is part of Zareen Abbas Khan’s doctoral work, and she is associated with Forhelse SFI (Centre for Research-based Innovation), work package 2: Cost-effectiveness. The task of the work package is to investigate whether digital psychological treatments are cost-effective, as well as factors that may have an impact on cost-effectiveness. Results from the article show the way to be able to standardize estimates of program costs for digital health interventions. Costs are calculated per patient.

In this paper, we firstly performed an extensive scoping review of scientific literature to identify the components of program costs of digital health interventions.

Secondly, we developed a program costs checklist based on the data extracted from the review. This checklist divides program costs into five main categories: development, research, maintenance, implementation and health personnel involvement. For each category, we offer examples of resource use and unit costs that can be used as a starting point for program cost estimation.

Thirdly, we applied the checklist to a case, Mamma Mia, a smartphone based application to prevent perinatal depression. The checklist proved useful and highlighted the significance of the various categories that comprise program costs. For example, even though health personnel involvement in Mamma Mia´s blended version is low, it more than doubled the program cost per patient. Similarly, the checklist helped illuminate areas for further research, for example, guidance on estimating the number of users for the program cost calculation of a digital health technology.

Behind the testing of the digital tool Mamma Mia is corporate partner ChangeTech together with the Regional Center for Child and Adolescent Mental Health, Health Region East and South.

In line with the scientific literature, our paper emphasizes that program costs of digital health interventions vary according to the complexity and maturity of the technology. Our checklist is flexible and can be adapted to fully automated, or artificially intelligent digital interventions, as well as interventions requiring a high degree of personnel support. It can also be used as a tool for iterative costing allowing the analyst to update program cost estimates as the intervention matures. In short, our literature-informed checklist is a first step to help standardize the program cost estimation of digital health interventions.