Table 1:

Teledermatology (TD) Cost-Effectiveness Studies

Author(s)	Year	Population	Modality Type	Method	Outcome
Wootton et al.	2000	UK: four health centers, two regional hospitals	Live-interactive	RCT	TD was more costly compared to conventional care (£132.1 vs. £48.7, US$159 vs. US$59). TD can be cost-saving in settings with greater traveling distances and lower equipment prices. No major differences in clinical outcomes.
Loane et al.	2001	New Zealand: rural health centers	Live-interactive	RCT	TD was less costly compared to conventional care from a societal perspective comparing total costs (NZ$279.2 vs. NZ$283.8, US$176 vs. US$179) and marginal costs (NZ$135 vs. NZ$284, US$85 vs. US$179)
Whited et al.	2003	US: unspecified	Store-and-forward	RCT	TD was more costly compared to conventional care but decreased time to treatment. TD can be cost-saving in settings with longer wait times.
Pak et al.	2009	Texas: Department of Defense affiliated clinics	Store-and-forward	RCT	TD was more costly compared to conventional care considering direct costs only ($294 vs. $283). Factoring in productivity loss, TD was cost-saving ($340 vs. $372).
Eminovic et al.	2010	Almere, Netherlands & Zeist, Netherlands: general district hospitals	Store-and-forward	RCT	TD was €32.5 (US$36) more costly compared to conventional care. TD can be cost-saving if distance to dermatologist is larger or when more consultations can be avoided.
Datta et al.	2015	Columbia, MO & Minneapolis, MN: two VA medical facilities	Store-and-forward	RCT	TD was similar in cost compared to conventional care considering direct costs only. Factoring in societal costs, TD was cost-saving. No evidence of difference in utility.
Livingston and Solomon	2015	Suburban Greater London: single general practice	Store-and-forward	Retrospective analysis	TD saved £12,460 (US$15,015) over a 3-year period by reducing secondary in-person visits. Patient satisfaction was high.
Snoswell et al.	2018	Australia	Store-and-forward	Retrospective analysis	Teledermoscopy for skin cancer referral and triage was A$54.6 (US$37) more costly but resulted in clinical resolution 26 days sooner
Vidal-Alaball et al.	2018	Bages, Spain: 14 primary health care teams	Store-and- forward	Retrospective analysis	TD saved £10,350 (US$12,452) per year in direct costs and £51,164 (US$61,555) in societal costs. Societal savings were most significant.
Yang et al.	2018	Philadelphia: underserved population in city health clinics	Store-and-forward	Retrospective analysis	27% of in-person visits and 3.3% of ER visits were avoided using TD. TD had cost savings of $10.00-$52.65 per consult.