Economic Evaluations of Mindfulness-Based Stress Reduction: A Systematic Review
Rebecca L. Acabchuk, Nana Amma O. O. Larbi, Patricia M. Herman, Vinicius Vieira Neves, Simon Benjamin Goldberg, Shufang Sun, Laura N. Haygood, Regan Gregory, Blair T Johnson, Eric B Loucks
October 29, 2026 preprint DOI: 10.31234/osf.io/f4wux_v1 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Randomized |
|---|---|
| Population | Clinical populations across healthcare settings, including chronic pain, mental health disorders, breast cancer survivorship, and pulmonary arterial hypertension |
| Intervention | Mindfulness-Based Stress Reduction (MBSR) |
| Measures | Quality of Health Economic Studies instrument, Consolidated Health Economic Evaluation Reporting Standards 2022 checklist |
| Topics | Meditation |
| Key findings | Across 12 economic evaluations, MBSR was associated with lower overall costs and equivalent or improved health outcomes compared with treatment-as-usual, with savings from reduced healthcare utilization and productivity losses generally offsetting intervention costs of $195 to $866 per participant. The authors conclude MBSR may represent a high-value nonpharmacologic intervention but note the need for economic evaluations in underrepresented populations and delivery models. |
Abstract
ObjectiveAs healthcare systems increasingly emphasize value-based care, evidence regarding the economic implications of nonpharmacologic interventions is needed to inform implementation and reimbursement decisions. This study aimed to assess the economic value of Mindfulness-Based Stress Reduction, identify clinical populations in which economic evaluations have been conducted, and assess the strength of the available economic evidence.DesignSystematic review of economic evaluations.Setting and ParticipantsAll clinical populations and healthcare settings. InterventionsMindfulness-Based Stress Reduction (MBSR).Evidence Review MethodsThis systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 guidelines and was prospectively registered. Nine databases, including MEDLINE, Embase and Scopus, were searched from inception through March 2026 without language restriction, with reference-list screening and citation tracking. Eligible studies evaluated Mindfulness-Based Stress Reduction and at least one economic outcome. Two reviewers independently screened records, extracted data, and assessed quality using the Quality of Health Economic Studies instrument and the Consolidated Health Economic Evaluation Reporting Standards 2022 checklist.ResultsAmong 468 identified records, 12 economic evaluations met inclusion criteria. Studies included 8 randomized clinical trials, 2 Markov models, and 2 prospective cohort studies, conducted in North America (6) and Europe (6). Chronic pain conditions were most frequent (6), followed by mental health disorders (3), breast cancer survivorship (2), and pulmonary arterial hypertension (1). Across these populations, reductions in healthcare utilization and productivity losses generally offset delivery costs, resulting in lower overall costs with equivalent or improved health outcomes for Mindfulness-Based Stress Reduction compared with treatment-as-usual. Results were also favorable or comparable relative to active comparators including cognitive behavioral therapy. Despite intervention costs of $195 to $866 per participant (mean, $461), all cost-utility analyses comparing Mindfulness-Based Stress Reduction with treatment-as-usual over at least 6 months reported lower costs with equivalent or improved outcomes. Methodological quality was high, with 10 of 12 studies meeting above 80% quality criteria and 5 achieving 100% adherence. Reporting transparency was generally strong.ConclusionsMindfulness-Based Stress Reduction was associated with favorable economic outcomes across chronic pain, mental health, and breast cancer survivorship populations. Current evidence suggests that MBSR may represent a high-value nonpharmacologic intervention, with reductions in healthcare utilization and productivity losses frequently offsetting intervention costs. Additional economic evaluations are needed in underrepresented populations, healthcare settings, and delivery models.
Comparable studies
Other systematic reviews and meta-analyses on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Meditation Programs for Psychological Stress and Well-being Diverse adult clinical populations | 2014 | Meta-analysis | n = 3,515 |
| Mindfulness-Based Stress Reduction for Stress Management in Healthy People: A Review and Meta-Analysis Healthy subjects | 2009 | Systematic review and meta-analysis | |
| The psychological effects of meditation: A meta-analysis. Nonclinical groups of adult meditators | 2012 | Meta-analysis | n = 163 |
| Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse Adults with recurrent depression in full or partial remission | 2016 | Meta-analysis of individual patient data from randomized controlled trials | n = 1,258 |
| Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy – a systematic review of randomized controlled trials | 2011 | Systematic review |