Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jan 4, 2023
Date Accepted: Apr 14, 2023
Cost-effectiveness analyses of digital health technology for improving the uptake of vaccination programs: A systematic review
ABSTRACT
Background:
Vaccination is the most effective strategy to prevent infectious diseases, yet vaccination coverage has not reached the target level. To promote the vaccination uptake, digital health interventions (DHIs) have been used in various vaccination programs.
Objective:
This study aimed to perform a systematic review of the cost-effectiveness analyses of DHIs for improving the uptake of vaccination programs.
Methods:
A literature review was conducted in Medline (Ovid), Embase (Ovid), APA PsycINFO (Ovid), Web of Science, Scopus, CINAHL Ultimate (EBSCOhost), Center for Review and Dissemination, and Institute for IEEE Xplore up to October 2022. Health economic evaluations that met the following inclusion criteria were included: (1) adult or pediatric vaccination programs; (2) interventions were delivered via digital technology; (3) full-scale health economic analyses including cost-effectiveness, cost-utility, cost-benefit or cost-consequence analyses; and (4) analyses conducted by model-based or trial-based. The quality of each included study was evaluated using the Consolidated Health Economic Evaluation Reporting Standards.
Results:
The systematic review included seven studies in total. Four of the cost-effectiveness analyses were conducted by modeling, and three were trial-based analyses. One study reported the additional cost per quality-adjusted life years gained, while six studies reported the additional cost per individual vaccinated (or return case). The vaccines targeted the human papillomavirus vaccine, influenza vaccination, measles-mumps-rubella vaccine, and children immunization at different ages. The DHIs were distributed via television campaign, web-based decision aid, short messaging service, telephone, and computer-generated recall letters. The studies were classified as very good (n=5) and good (n=2) quality. One study concluded that the DHI was cost-saving, and six studies concluded that the DHI was cost-effective.
Conclusions:
This study is the first systematic review on cost-effectiveness analyses of DHIs to improve the vaccination uptake. All included studies have good to very good quality on study assessment, and reported the DHIs to be cost-saving to cost-effective in improving vaccination uptake.
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