How to Measure Costs and Benefits of eHealth Interventions: An Overview of Methods and Frameworks

J Med Internet Res. 2015 Nov 9;17(11):e254. doi: 10.2196/jmir.4521.


Information on the costs and benefits of eHealth interventions is needed, not only to document value for money and to support decision making in the field, but also to form the basis for developing business models and to facilitate payment systems to support large-scale services. In the absence of solid evidence of its effects, key decision makers may doubt the effectiveness, which, in turn, limits investment in, and the long-term integration of, eHealth services. However, it is not realistic to conduct economic evaluations of all eHealth applications and services in all situations, so we need to be able to generalize from those we do conduct. This implies that we have to select the most appropriate methodology and data collection strategy in order to increase the transferability across evaluations. This paper aims to contribute to the understanding of how to apply economic evaluation methodology in the eHealth field. It provides a brief overview of basic health economics principles and frameworks and discusses some methodological issues and challenges in conducting cost-effectiveness analysis of eHealth interventions. Issues regarding the identification, measurement, and valuation of costs and benefits are outlined. Furthermore, this work describes the established techniques of combining costs and benefits, presents the decision rules for identifying the preferred option, and outlines approaches to data collection strategies. Issues related to transferability and complexity are also discussed.

Keywords: cost-benefit analysis; cost-effectiveness analysis; cost-utility analysis; eHealth; economic evaluation; health economics; quality-adjusted life years (QALYs); telehealth; telemedicine; telemonitoring.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Cost-Benefit Analysis / economics*
  • Cost-Benefit Analysis / methods*
  • Cost-Benefit Analysis / trends
  • Data Collection / economics*
  • Decision Making
  • Humans
  • Quality-Adjusted Life Years
  • Telemedicine / economics*