Journal of Economics Intelligence And Technology

Abstract: Background: Integrated behavioral health services are being touted as more effective at achieving better health results and enhancing system efficiency. The economic evaluation frameworks employed in these systems, however, remain methodologically inconsistent in informing the decision-making procedure. There have been recent developments such as equity-sensitive methods and multi-criteria decision analysis (MCDA), which have broadened the range of traditional methods of evaluation. Objective: To conduct a systematic review of economic evaluation frameworks applied to integrated behavioral health (IBH) and the inclusion of economic considerations on cost-effectiveness, equity, and multi-criteria approaches for the most recent evidence (2020-2025). Methods:A systematic review was conducted based on the PRISMA guidelines. An in-depth literature search was conducted in PubMed/MEDLINE, Scopus, Web of Science, EconLit, and PsycINFO to find peer-reviewed literature from January 2020 to March 2025. Eligible studies such as economic evaluations or methodological frameworks for integrated or behavioral health systems are used. The study characteristics, evaluation methods, and decision-making frameworks were extracted and synthesized in a narrative manner. Results: Across 35 studies included, integrated behavioral health interventions were generally found to be cost-effective, especially in the longer term. There is considerable variation in the method of costing, outcome measurement, and analytic methods, however. Traditional cost-effectiveness approaches did not always include multi-dimensional outcomes and equity implications. Distributional cost-effectiveness analysis (DCEA) and MCDA were emerging methods that could be used to overcome these limitations but were not used consistently. Conclusion: For integrated behavioral health, economic evaluation is transitioning to more holistic and equity-focused evaluations. To make the economic evidence more relevant to policy and decision-making, there is a need for greater methodological standardization, better outcome measures, and incorporating stakeholder perspectives.