{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T02:03:59Z","timestamp":1792116239774,"version":"4.4.0"},"reference-count":42,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pulmonary rehabilitation, a nonpharmacological treatment for chronic respiratory diseases, is underused due to limited access and time constraints. In a randomized controlled trial, the digital therapeutics (DTx) demonstrated superior efficacy to standard treatment. However, evidence on the cost-effectiveness of DTx and appropriate pricing strategies remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate the cost-effectiveness of DTx through cost-utility analysis and to explore a value-based price for its implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An economic evaluation was based on an 8-week randomized controlled trial involving 84 participants assigned to either the DTx group or standard treatment group. Costs were estimated from a health care system perspective. Quality-adjusted life years (QALYs) were estimated by using mapping algorithms from the chronic obstructive pulmonary disease assessment test to EQ-5D-3L. 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 US $19,410 per QALY. Sensitivity analyses included probabilistic sensitivity analysis, deterministic sensitivity analysis, and subgroup and scenario analyses, including a 1-year Markov model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with standard treatment, DTx increased QALY by 0.0096 at an additional cost of US $85.33, resulting in an ICUR of US $8890 per QALY gained. The maximum value-based price for an 8-week DTx program was estimated at US $192. In probabilistic sensitivity analysis, DTx had a 60.2% probability of being cost-effective at the set willingness-to-pay threshold, with 88.6% of iterations in the northeast quadrant falling below the threshold. The deterministic sensitivity analysis showed that ICURs remained below the willingness-to-pay threshold under all tested assumptions, with the maximum ICUR (US $15,644\/QALY) also staying below the threshold. Subgroup analysis confirmed cost-effectiveness in both older adults (\u226565 y) and non\u2013older adults (&lt;65 y) populations, and in both chronic obstructive pulmonary disease and interstitial lung disease groups. The 1-year Markov model estimated an ICUR of US $4398 per QALY.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DTx for pulmonary rehabilitation demonstrated the cost-effectiveness compared with standard treatment. These findings support its potential for improving outcomes in patients with chronic respiratory disease and provide a pricing framework to facilitate its integration into health care systems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/73739","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T13:35:11Z","timestamp":1761226511000},"page":"e73739","source":"Crossref","is-referenced-by-count":5,"title":["Cost-Utility Analysis and Value-Based Pricing of Digital Therapeutics for Pulmonary Rehabilitation in Chronic Respiratory Disease: Economic Evaluation Based on a Randomized Controlled Trial"],"prefix":"10.2196","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-6733-2855","authenticated-orcid":false,"given":"Hyeonjung","family":"Park","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5631-4685","authenticated-orcid":false,"given":"Minseol","family":"Jang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7799-5003","authenticated-orcid":false,"given":"Daehyun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8223-2945","authenticated-orcid":false,"given":"Chul","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9003-0032","authenticated-orcid":false,"given":"Jun Hyeong","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0756-3810","authenticated-orcid":false,"given":"Ju Hyun","family":"Oh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4533-7937","authenticated-orcid":false,"given":"Chin Kook","family":"Rhee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0932-2826","authenticated-orcid":false,"given":"Jae Ha","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8753-929X","authenticated-orcid":false,"given":"Hee-Eun","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3445-6607","authenticated-orcid":false,"given":"Hae Sun","family":"Suh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,12,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32279-7"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.101936"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-014616"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-20-2100"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1136\/thorax-2023-220439"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202306-1066ST"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2013-204227"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00145613"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201309-1634ST"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02151-2015"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.3390\/life14040469"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.155.4.9105067"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2021-218338"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1097\/CMR.0000000000000919"},{"key":"ref15","author":"Drummond, 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