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Objectives: To systematically review cost benefit studies of telemedicine.

Design: Systematic review of English language, peer reviewed journal articles.

Data sources: Searches of Medline, Embase, ISI citation indexes, and database of Telemedicine Information Exchange.

Studies selected: 55 of 612 identified articles that presented actual cost benefit data.

Main outcome measures: Scientific quality of reports assessed by use of an established instrument for adjudicating on the quality of economic analyses.

Results: 557 articles without cost data categorised by topic. 55 articles with data initially categorised by cost variables employed in the study and conclusions. Only 24/55 (44%) studies met quality criteria justifying inclusion in a quality review. 20/24 (83%) restricted to simple cost comparisons. No study used cost utility analysis, the conventional means of establishing the “value for money” that a therapeutic …