JMIR Publications

ABSTRACT

Background:

Pulmonary rehabilitation, a non-pharmacological treatment for chronic respiratory diseases (CRD), is underutilized due to limited access and time constraints. In a randomized controlled trial, the digital therapeutic (DTx) EASYBREATH showed superior efficacy to standard treatment. However, evidence on the cost-effectiveness of DTx and appropriate pricing strategies remains limited.

Objective:

This study aimed to assess the cost-effectiveness of DTx through cost-utility analysis and to explore value-based pricing.

Methods:

This economic evaluation was based on an 8-week rehabilitation trial involving 84 participants randomized into either the DTx group or standard treatment group. Costs were estimated from a healthcare system perspective. Quality-adjusted life years (QALY) were estimated by using mapping algorithms to COPD Assessment Test. Cost-utility analysis was conducted to estimate the incremental cost-utility ratio (ICUR), which represents the additional cost per QALY gained. The willingness-to-pay threshold was set at $19,410 per QALY, the Korean Gross Domestic Product per capita in 2006. Scenario, subgroup, and deterministic analyses were performed, along with probabilistic sensitivity analysis using 1,000 simulations.

Results:

Compared to standard treatment, DTx increased QALY by 0.0096 at an additional cost of $85.33, resulting in an ICUR of $8,922 per QALY gained. The maximum value-based price for an 8-week DTx program was estimated at $192. In probabilistic sensitivity analysis, DTx had a 60.2% probability of being cost-effective at the threshold. Subgroup analysis showed that the ICUR remained below the threshold in both elderly (≥65 years, $10,486 per QALY) and the non-elderly (<65 years, $6,784 per QALY) groups.

Conclusions:

DTx for pulmonary rehabilitation was cost-effective compared to standard treatment. These findings highlight its potential benefits for patients with CRD and support its integration into current healthcare systems.