Wilkinson T, Wang M, Friedman J, Gaye YE, Gorgens M. Knowing when digital adds value to health: a framework for the economic evaluation of digital health interventions. Oxf Open Digit Health. 2024;2(Suppl 2):ii75-ii86. doi:10.1093/oodh/oqae028cost-effectiveness, development, digital health, scalability, dissemination and implementation
This paper explains a framework to guide the planning, conduct, and reporting of economic evaluation of digital health interventions (DHI). The aim is to increase the scalability of digital interventions and highlight when digital delivery makes an impact on the utility of the intervention. The framework was grounded in the WHO’s guide to monitoring and evaluating digital health interventions, but with novel tailored insights into DHI economic evaluation. Step 1 is to identify and represent the context of the economic evaluation. Establishing the digital architecture of where the DHI will be implemented is key. Step 2 is to determine the intervention type. In this step not only should a general description be completed but the DHI should be assigned to a WHO DHI type and specify if there will be a predictive analysis component. Step 3 is to establish the level of complexity. Here, intervention complexity, causal pathway complexity, and outcome complexity should all be considered and addressed. In step 4, apply analytical principles, comparator, timeframe, costs, benefits, predictive analysis, and uncertainty should be applied to the DHI. In the final step, represent the value proposition, the value proposition should be shown as an impact inventory (health impact, health system impact, user-experience impact, value of data, cross-sectoral impact) and a formal compilation intended to be examined by the decision maker. This final step may include benefit-cost analysis, cost-utility analysis, cost-effectiveness analysis, and social return on investment. This framework may be used across a wide range of resources and should not be considered a black-and-white rulebook.