Cost-effectiveness analysis of a digital health-enabled non-communicable disease management intervention: Evidence from Ghana

Background: Diabetes and hypertension are major contributors to Ghana’s health burden, yet conventional non-communicable disease (NCD) management remains reactive and resource-intensive. Technology- driven interventions present great potential solutions. The Akoma Pa initiative which integrates digital health solutions to improve early screening, management, and patient support was piloted. This study evaluates its cost-effectiveness, providing evidence to guide resource allocation and policy decisions for sustainable NCD care in Ghana. Methods: This study performed a cost-effectiveness analysis (CEA) of the Akoma Pa program versus conventional method of managing diabetes and hypertension in Christian Health Facilities in Ghana. The evaluation was conducted retrospectively from January to December 2023. Using mixed methods, data from 705 hypertensive and diabetic patients across 16 health facilities was analysed. Costs, health outcomes, and incremental cost-effectiveness ratios (ICERs) were assessed, with one-way sensitivity analyses to test the robustness of the results. Results: The Akoma Pa intervention significantly improved patient outcomes and demonstrated strong cost-effectiveness. Compared to conventional care, it achieved higher follow-up rates (89% vs. 36.5%), greater reductions in HbA1c (-2.10% vs. -1.68%), fasting blood glucose (-2.21 mmol/L vs. -1.89 mmol/L), and systolic blood pressure (-54.38 mmHg vs. -51.88 mmHg). Negative ICER values confirmed cost savings, including HbA1c (-$51,043.79), fasting blood glucose (-$66,994.97), and systolic blood pressure (-$8,575.36). Sensitivity analysis reinforced the robustness of these findings. Conclusion: The Akoma Pa program shows that digital health interventions are not only clinically effective but also economically beneficial. These findings support adoption of digital health solutions to improve health outcomes and promote economic sustainability in healthcare systems.