How to Value Digital Health Interventions? A Systematic Literature Review
Open Access
- 23 March 2020
- journal article
- review article
- Published by MDPI AG in International Journal of Environmental Research and Public Health
- Vol. 17 (6), 2119
- https://doi.org/10.3390/ijerph17062119
Abstract
In Europe, there were almost twice as many patents granted for medical technology (13,795) compared to pharmaceuticals (7441) in 2018. It is important to ask how to integrate such an amount of innovations into routine clinical practice and how to measure the value it brings to the healthcare system. Given the novelty of digital health interventions (DHI), one can even question whether the quality-adjusted life years (QALY) approach developed for pharmaceuticals can be used or whether we need to develop a new DHI’s value assessment framework. We conducted a systematic literature review of published DHIs’ assessment guidelines. Each publication was analyzed with a 12-items checklist based on a EUnetHTA core model enriched with additional criteria such as usability, interoperability, and data security. In total, 11 value assessment guidelines were identified. The review revealed that safety, clinical effectiveness, usability, economic aspects, and interoperability were most often discussed (seven out of 11). More than half of the guidelines addressed organizational impact, data security, choice of comparator, and technical considerations (six out of 11). The unmet medical needs (three out of 11), along with the ethical (two out of 11) and legal aspects (one out of 11), were given the least attention. No author provided an analytical framework for the calculation of clinical and economic outcomes. We elicited five recommendations for the choice of DHI’s value criteria and a methodological suggestion for the pricing and reimbursement framework. Our conclusions lead to the need for a new DHI’s value assessment framework instead of a QALY approach.Keywords
This publication has 6 references indexed in Scilit:
- Improving Interoperability between Registries and EHRs2018
- mHealth Assessment: Conceptualization of a Global FrameworkJMIR mHealth and uHealth, 2017
- Guidelines for reporting of health interventions using mobile phones: mobile health (mHealth) evidence reporting and assessment (mERA) checklistBMJ, 2016
- A MODEL FOR ASSESSMENT OF TELEMEDICINE APPLICATIONS: MASTInternational Journal of Technology Assessment in Health Care, 2012
- An assessment framework for telemedicine applications.Journal of Telemedicine and Telecare, 1999
- A Proposed Framework for Economic Evaluation of TelemedicineTelemedicine Journal, 1998