Economic Evaluations of Mindfulness-Based Stress Reduction: A Systematic Review

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.