Tehran University of Medical Sciences Health Technology Assessment in Action 2645-3835 3 1 2020 05 10 18 18 Mohsen Pakdaman Health Policy and Management Research Center, Department of Health Care Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Maryam Nazari Moghadam Department of Health Technology Assessment, school of public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Hamid Reza Dehghan Department of Health Technology Assessment, school of public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Arezoo Dehghani Department of Health Technology Assessment, school of public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Mahdieh Namayandeh Department of Statistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 2019 10 13 2019 11 18 Context: Recent advances in information technology and electronic devices, as well as limitations in traditional education, have persuaded higher education systems to use the virtual model as an alternative. The present systematic review aimed at evaluating the cost-effectiveness of both the traditional and virtual education models. Methods: In this systematic review, articles published in known English and Persian databases, such as MEDLINE (PubMed), Scopus, Science Direct, HTA, Cochrane, Irandoc, Magiran, and SID from 2007 to 2017 were retrieved. Studies on health technologies and economic were also reviewed. For this purpose, the hierarchical search algorithm and the keywords “e-Learning” and “traditional education” were used. Results: Ten studies were included, and their results were slightly different. Most studies showed that the cost-effectiveness of virtual education alone or in combination with traditional education (blended model) was equal or greater than that of traditional education. The data analysis of the articles was performed by comparing cost, effectiveness (Min, SD, QASE), cost-effectiveness (ICER), and the average cost per student. Cost-effectiveness refers to achieve the highest output at the lowest cost. The results showed that due to the use of multimedia, lack of space and time limitations, admission of a large number of students, the increased student satisfaction, easy and fast access to information, and use of Sharable Content Object Reference model in producing content and instruction, distance higher education reduces education costs while compensating for the lack of human resources in the teaching-learning process. Conclusion: One of the effective methods in the education of medical students seems to be Web-based teaching as traditional teaching. Considering the predominance of the web-based method, it is recommended to be used in educational programs in the universities.   https://htainaction.tums.ac.ir/index.php/hta/article/view/18 https://htainaction.tums.ac.ir/index.php/hta/article/download/18/19