Systematic review on the cost and cost-effectiveness of mHealth interventions supporting women during pregnancy

• Published in: Women and birth : journal of the Australian College of Midwives Vol. 36; no. 1; pp. 3 - 10
• Main Authors: Carrandi, Alayna, Hu, Yanan, Karger, Shae, Eddy, Katherine E., Vogel, Joshua P., Harrison, Cheryce L., Callander, Emily
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.02.2023
• Subjects: Apps; Cost-Benefit Analysis; Cost-effectiveness; Female; Humans; Maternal Health Services; mHealth; Pregnancy; Review; Telemedicine; ICER; USD; mHealth; PRISMA; Review; CHEERS; Apps; Pregnancy; DALY; QALY; SMS; NHS; LMIC; ICT; Cost-effectiveness
• ISSN: 1871-5192; 1878-1799
• DOI: 10.1016/j.wombi.2022.03.007

The increased integration of digital health into maternity care—alongside growing use of, and access to, personal digital technology among pregnant women—warrants an investigation of the cost-effectiveness of mHealth interventions used by women during pregnancy and the methodological quality of the cost-effectiveness studies. A systematic search was conducted to identify peer-reviewed studies published in the last ten years (2011–2021) reporting on the costs or cost-effectiveness of mHealth interventions used by women during pregnancy. Available data related to program costs, total incremental costs and incremental cost-effectiveness ratios (ICERs) were reported in 2020 United States Dollars. The quality of cost-effectiveness studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS). Nine articles reporting on eight studies met the inclusion criteria. Direct intervention costs ranged from $7.04 to $86 per woman, total program costs ranged from $241,341 to $331,136 and total incremental costs ranged from -$21.16 to $1.12 million per woman. The following ICERs were reported: $2168 per DALY averted, $203.44 per woman ceasing smoking, and $3475 per QALY gained. The full economic evaluation studies (n = 4) were moderate to high in quality and all reported the mHealth intervention as cost-effective. Other studies (n = 4) were low to moderate in quality and reported low costs or cost savings associated with the implementation of the mHealth intervention. Preliminary evidence suggests mHealth interventions may be cost-effective and “low-cost” but more evidence is needed to ascertain the cost-effectiveness of mHealth interventions regarding positive maternal and child health outcomes and longer-term health service utilisation.