Bulletin of Semashko National Research Institute of Public HealthBulletin of Semashko National Research Institute of Public Health2415-84102415-8429FSSBI «N.A. Semashko National Research Institute of Public Health»328110.69541/NRIPH.2026.03.018Original ArticleAssessment of the Economic Efficiency of Digital Technology Implementation in the Healthcare SystemMukhachevaAnna Valentinovnaoblakkko@mail.ruKadyrovFarit Nakipovichkadyrov@mednet.ruSubkhangulovaKsenia Almirovnaksubkhangulova@yandex.ruChililovAbdula Magomedovichchililov@mail.ruPlekhanov Russian University of Economics, 115054, Russia, Moscow, Russian FederationThe Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow, Russian FederationA. V. Vishnevsky National Medical Research Center of Surgery, Moscow, Russian Federation02102026311612307102026Copyright © 2026,2026Annotation. This article provides a comprehensive analysis of methodological approaches to assessing the economic efficiency of healthcare digitalization based on the systematization of international and domestic experience using bibliographic databases such as MEDLINE, PubMed, Springer Nature Link, and ResearchGate. The relevance of the study is determined by the growing scale of healthcare digitalization against the backdrop of a lack of universal and standardized methods for evaluating its economic efficiency. The shortage of reliable tools for comparative analysis of the cost and effectiveness of digital solutions creates serious obstacles for their scaling and informed budget planning. The study results show the inconsistency of the global evidence base: the economic feasibility of digital solutions heavily depends on the chosen metrics (QALY, ICER, etc.) and willingness-to-pay thresholds. In international practice, the most proven interventions are those based on text messaging and video conferencing for managing chronic diseases. An analysis of the Russian context revealed key barriers: an underdeveloped regulatory framework for AI, restrictions on using market profitability indicators in the public OMS sector, and high regional variability in costs.economic efficiency assessment, healthcare digitalization, digital technologies, artificial intelligence, telemedicine technologies, clinical and economic analysis.оценка экономической эффективности, цифровизация здравоохранения, цифровые технологии, искусственный интеллект, телемедицинские технологии, клинико-экономический анализ.Taryudi T., Mutiar A., Supriatin E., Lindayani L. Digital media literacy level among nurses in urban area of Indonesia. Int Public Health J. 2021;13(2):213—218.Mendoza G., Okoko L., Konopka S., Jonas E. mHealth Compendium, Volume Three. Arlington, VA: African Strategies for Health project, Management Sciences for Health; 2013.Whetten J., van der Goes D. N., Tran H., Moffett M., Semper C., Yonas H. Cost-effectiveness of access to critical cerebral emergency support services (ACCESS): a neuro-emergent telemedicine consultation program. J Med Econ. 2018;(21):398—405. DOI: 10.1080/13696998.2018.1426591Gentili A., Failla G., Melnyk A., et al. The cost-effectiveness of digital health interventions: A systematic review of the literature. Front. Public Health. 2022;(10):787135. DOI: 10.3389/fpubh.2022.787135Fusco F., Turchetti G. Telerehabilitation after total knee replacement in Italy: cost-effectiveness and cost-utility analysis of a mixed telerehabilitation-standard rehabilitation programme compared with usual care. BMJ Open. 2016;(6):e009964. DOI: 10.1136/bmjopen-2015-009964Thakar S., Rajagopal N., Mani S., Shyam M., Aryan S., Rao A. S. Comparison of telemedicine with in-person care for follow-up after elective neurosurgery: results of a cost-effectiveness analysis of 1200 patients using patient-perceived utility scores. Neurosurg Focus. 2018;(44):E17. DOI: 10.3171/2018.2.FOCUS17543Lugo V. M., Garmendia O., Suarez-Girón M., Torres M., Vázquez-Polo F. J., Negrín M. A. Comprehensive management of obstructive sleep apnea by telemedicine: clinical improvement and cost-effectiveness of a virtual sleep unit. A randomized controlled trial. PLoS ONE. 2019;(14):e0224069. DOI: 10.1371/journal.pone.0224069Nguyen H. V., Tan G. S.W., Tapp R. J., Mital S., Ting D. S.W., Wong H. T.Cost-effectiveness of a National Telemedicine Diabetic Retinopathy Screening Program in Singapore. Ophthalmology. 2016;(123):2571—2580. DOI: 10.1016/j.ophtha.2016.08.021Wan W., Nathan A. G., Skandari M. R., Zarei P., Reid M. W., Raymond J. K. Cost-effectiveness of shared telemedicine appointments in young adults with T1D:CoYoT1 trial. Diabetes Care. 2019;(42):1589—1592. DOI: 10.2337/dc19-0363Yoo B.-K., Kim M., Sasaki T., Melnikow J., Marcin J. P. Economic evaluation of telemedicine for patients in ICUs. Crit Care Med. 2016;(44):265—274. DOI: 10.1097/CCM.0000000000001426Oksman E., Linna M., Hörhammer I., Lammintakanen J., Talja M. Cost-effectiveness analysis for a tele-based health coaching program for chronic disease in primary care. BMC Health Serv Res. 2017;(17):138. DOI: 10.1186/s12913-017-2088-4Oostingh E. C., Ophuis R. H., Koster W. P.H., et al. Mobile health coaching on nutrition and lifestyle behaviors for subfertile couples using the smarter pregnancy program: model-based cost-effectiveness analysis. JMIR Mhealth Uhealth. 2019;(7):e13935. DOI: 10.2196/preprints.13935Islam M., Peiffer R., Chow C. K., et al. Cost-effectiveness of a mobile-phone text messaging intervention on type 2 diabetes—a randomized-controlled trial. Health Policy Technol. 2020;(9):79—85. DOI: 10.1016/j.hlpt.2019.12.003Jo Y., LeFevre A. E., Healy K., et al. Costs and cost-effectiveness analyses of mCARE strategies for promoting care seeking of maternal and newborn health services in rural Bangladesh. PLoS ONE. 2019;(14):e0223004. DOI: 10.1371/journal.pone.0223004O’Sullivan E. J., Rokicki S., Kennelly M., et al. Cost-effectiveness of a mobile health-supported lifestyle intervention for pregnant women with an elevated body mass index. Int J Obes. 2020;(44):999—1010. DOI: 10.1038/s41366-020-0531-9Cleghorn C., Wilson N., Nair N., Kvizhinadze G., Nghiem N., McLeod M. Health benefits and cost-effectiveness from promoting smartphone apps for weight loss: multistate life table modeling. JMIR Mhealth Uhealth. 2019;(7):e11118. DOI: 10.2196/11118Romero-Sanchiz P., Nogueira-Arjona R., García-Ruiz A., Luciano J. V., Campayo J. G., Gili M. Economic evaluation of a guided and unguided internet-based CBT intervention for major depression: results from a multicenter, three-armed randomized controlled trial conducted in primary care. PLoS ONE. 2017;12:e0172741. DOI: 10.1371/journal.pone.0172741Watson H. J., McLagan N., Zerwas S. C., Crosby R. D., Levine M. D., Runfola C. D. Cost-effectiveness of internet-based cognitive-behavioral treatment for bulimia nervosa: results of a randomized controlled trial. J Clin Psychiatry. 2018;(79):16m11314. DOI: 10.4088/JCP.16m11314Nordyke R. J., Appelbaum K., Berman M. A. Estimating the impact of novel digital therapeutics in type 2 diabetes and hypertension: health economic analysis. J Med Internet Res. 2019;(21):e15814. DOI: 10.2196/preprints. 15814Sharifi M., Franz C., Horan C. M., Giles C. M., Long M. W., Ward Z. J. Cost-effectiveness of a clinical childhood obesity intervention. Pediatrics. 2017;(140):e20162998. DOI: 10.1542/peds.2016—2998Sjostrom M., Lindholm L., Samuelsson E. Mobile app for treatment of stress urinary incontinence: a cost-effectiveness analysis. J Med Internet Res. 2017;(19):e154. DOI: 10.2196/jmir.7383Kumar S., Bell M. J., Juusola J. L. Mobile and traditional cognitive behavioral therapy programs for generalized anxiety disorder: a cost-effectiveness analysis. PLoS ONE. 2018;(13):e0190554. DOI: 10.1371/journal.pone.0190554Song M., Kanaoka H. Effectiveness of mobile application for menstrual management of working women in Japan: randomized controlled trial and medical economic evaluation. J Med Econ. 2018;(21):1131—1138. DOI: 10.1080/13696998.2018.1515082Modi D., Saha S., Vaghela P., Dave K., Anand A., Desai S. Costing and cost-effectiveness of a mobile health intervention (ImTeCHO) in improving infant mortality in tribal areas of Gujarat, India: cluster randomized controlled trial. JMIR Mhealth Uhealth. 2020;(8):e17066. DOI: 10.2196/17066Lowry K. P., Trentham-Dietz A., Schechter C. B., Alagoz O., Barlow W. E., Burnside E. S. Long-term outcomes and cost-effectiveness of breast cancer screening with digital breast tomosynthesis in the United States. J Natl Cancer Inst. 2020;(112):582—589. DOI: 10.1093/jnci/djz184Prinja S., Bahuguna P., Gupta A., Nimesh R., Gupta M., Thakur J. S. Cost effectiveness of mHealth intervention by community health workers for reducing maternal and newborn mortality in rural Uttar Pradesh, India. Cost Eff Resour Alloc. 2018;(16):25. DOI: 10.1186/s12962-018-0110-2Bahrainwala L., Knoblauch A. M., Andriamiadanarivo A., Diab M. M., McKinney J., Small P. M. Drones and digital adherence monitoring for community-based tuberculosis control in remote Madagascar: a cost-effectiveness analysis. PLoS ONE. 2020;(15):e0235572. DOI: 10.1371/journal.pone.0235572Iribarren S. J., Cato K., Falzon L., Stone P. W. What is the economic evidence for mHealth? A systematic review of economic evaluations of mHealth solutions. PLoS ONE. 2017;(12):e0170581. DOI: 10.1371/journal.pone.0170581De La Torre-Diéz I., López-Coronado M., Vaca C., Aguado J. S., De Castro C. Cost-utility and cost-effectiveness studies of telemedicine, electronic, and mobile health systems in the literature: a systematic review. Telemed J E Health. 2015;(21):81—85. DOI: 10.1089/tmj.2014.0053Vestergaard A. S., Hansen L., Sorensen S. S., Jensen M. B., Ehlers L. H. Is telehealthcare for heart failure patients cost-effective? An economic evaluation alongside the Danish TeleCare North heart failure trial. BMJ Open. 2020;(10):e031670. DOI: 10.1136/bmjopen-2019-031670Painter J. T., Fortney J. C., Austen M. A., Pyne J. M. Cost-effectiveness of telemedicine-based collaborative care for posttraumatic stress disorder. Psychiatr Serv. 2017;(68):1157—1163. DOI: 10.1176/appi.ps.201600485Clarke M., Fursse J., Brown-Connolly N. E., Sharma U., Jones R. Evaluation of the National Health Service (NHS) direct pilot telehealth program: cost-effectiveness analysis. Telemed E Health. 2018;(24):67—76. DOI: 10.1089/tmj.2016.0280Lopez-Villegas A., Catalan-Matamoros D., Peiro S., Lappegard K. T., Lopez-Liria R. Cost—utility analysis of telemonitoring versus conventional hospital-based follow-up of patients with pacemakers. The NORDLAND randomized clinical trial. PLoS ONE. 2020;(15):e0226188. DOI: 10.1371/journal.pone.0226188Witt Udsen F., Lilholt P. H., Hejlesen O., Ehlers L. Cost-effectiveness of telehealthcare to patients with chronic obstructive pulmonary disease: results from the Danish ‘TeleCare North’ cluster-randomised trial. BMJ Open. 2017;(7):e014616. DOI: 10.1136/bmjopen-2016-014616Morozov D. Yu., Gorkavenko F. V., Seryapina Yu. V., Omelyanovsky V. V. Application of the Webiomed. DHRA medical decision support system during medical examinations in the Russian Federation: an economic analysis. Medical Technologies. Assessment and Choice. [Meditsinskiye tekhnologii. Otsenka i vybor]. 2025;47(3):61—73 (in Russian). DOI: 10.17116/medtech20254703161Vasiliev Yu. A., Tyrov I. A., Vladzimirsky A. V., Voloshin R. I., Golikova A. Yu., Shulkin I. M. Productivity of living labor in radiation diagnostics: monograph. Moscow: State Budgetary Healthcare Institution «Research and Clinical Center for Diagnostics and Telecommunications, Department of Health of the City of Moscow»; 2025 (in Russian).