Effectiveness and cost-effectiveness of incentives as a tool for prevention of non-communicable diseases: A systematic review.


Journal Article (Review)

The rising epidemic of non-communicable diseases (NCDs) poses substantial health and economic challenges to both individuals and society. Application of incentive-based strategies based on traditional and behavioural economic theory has emerged as a potential strategy to address rising rates of NCDs. Yet, whether or not incentives truly represent a promising strategy for addressing NCDs has not been systematically addressed nor is it clear whether certain behavioural economic strategies outperform others or simply offering a cash-based incentive for meeting a goal. In this systematic review we aim to determine whether there is an evidence base for any of these strategies. Forty-eight published randomized controlled trials (70 contrasts) evaluating the effectiveness of incentive-based strategies for improvements in NCD risk-factors were reviewed. Our primary conclusion is that there is a lack of compelling evidence that incentives of any form represent a compelling NCD reduction strategy. More evidence for long-term effectiveness and cost-effectiveness is needed to justify third party funding of any incentive based strategy.

Full Text

Duke Authors

Cited Authors

  • Finkelstein, EA; Bilger, M; Baid, D

Published Date

  • July 2019

Published In

Volume / Issue

  • 232 /

Start / End Page

  • 340 - 350

PubMed ID

  • 31129504

Pubmed Central ID

  • 31129504

Electronic International Standard Serial Number (EISSN)

  • 1873-5347

International Standard Serial Number (ISSN)

  • 0277-9536

Digital Object Identifier (DOI)

  • 10.1016/j.socscimed.2019.05.018


  • eng