• Elena Agachi, Jochen O Mierau, Koert van Ittersum, and Tammo H A Bijmolt.
• Faculty of Economics and Business, University of Groningen, PO Box 800, Groningen 9700 AV, The Netherlands. Electronic address: agachielena@gmail.com.
• Prev Med. 2024 Nov 10; 189: 108174108174.

ObjectiveRecognizing the substantial role of modifiable risk factors such as physical inactivity, unhealthy diets, and substance use in driving global healthcare expenses, this study aims to assess the impact of a lifestyle behaviour change mobile health (mHealth) app on healthcare costs within a real-world setting.MethodsEmploying a difference-in-difference approach, this research compared healthcare costs between users of an mHealth app (treatment group) and a propensity score-matched control group of non-users. The study included data from 15,506 participants in the Netherlands, covering healthcare cost records collected from 2015 to 2019.ResultsThe implementation of the mHealth app was linked to a steady reduction in healthcare costs, achieving a 4.9 % decrease (β=-0.05,95%CI:-0.10to0.00) during the first year following the program's implementation, and a further 5.3 % decrease (β=-0.05,95%CI:-0.10to-0.00) in the second year. This healthcare costs reduction is associated with lower expenses for general practitioner services as well as diminished specialist visits. Additionally, increased app use led to further cost reductions, with frequency of use proving more important than intensity.ConclusionsThis study demonstrates that a behaviour change mHealth app is linked to significant reductions in healthcare costs, with more frequent and intense use leading to greater savings. Given their relatively low cost and ability to reach diverse population groups, such apps not only enhance individual health outcomes but can also serve as effective policy tools for large-scale health promotion, supporting broader societal health improvements.Copyright © 2024. Published by Elsevier Inc.

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