Cost of mHealth Versus Clinic-Based Care for Serious Mental Illness: Same Effects, Half the Price Tag

Objective: This study compared the costs of implementing a smartphone-delivered mobile health (mHealth) intervention (called FOCUS) with the costs of implementing a clinic-based group intervention (Wellness Recovery Action Planning [WRAP]) for serious mental illness. Treatments were delivered in parallel in a randomized controlled trial and produced comparable clinical outcomes. Methods: Retrospective cost data were collected by using mixed-methods, top-down expenditure analysis with microcosting procedures. Costs were organized by input categories, including personnel, supplies, equipment, overhead, and indirect costs. All estimates are reported in US$. Results: The average annual cost to providers was $78,212 for WRAP and $40,439 for FOCUS. In both groups, labor accounted for the largest cost, followed by indirect costs and overhead costs. When indirect costs were excluded, WRAP cost $520 per client per month, compared with $256 for FOCUS. Conclusions: mHealth produced the same patient outcomes as clinic-based group treatment at approximately half the cost.