Cost-Effectiveness Analysis in Telehealth: A Comparison between Home Telemonitoring, Nurse Telephone Support, and Usual Care in Chronic Heart Failure Management.
Value Health
; 21(7): 772-782, 2018 07.
Article
em En
| MEDLINE
| ID: mdl-30005749
ABSTRACT
OBJECTIVES:
To assess the cost effectiveness of home telemonitoring (HTM) and nurse telephone support (NTS) compared with usual care (UC) in the management of patients with chronic heart failure, from a third-party payer's perspective.METHODS:
We developed a Markov model with a 20-year time horizon to analyze the cost effectiveness using the original study (Trans-European Network-Home-Care Management System) and various data sources. A probabilistic sensitivity analysis was performed to assess the decision uncertainty in our model.RESULTS:
In the original scenario (which concerned the cost inputs at the time of the original study), HTM and NTS interventions yielded a difference in quality-adjusted life-years (QALYs) gained compared with UC 2.93 and 3.07, respectively, versus 1.91. An incremental net monetary benefit analysis showed 7,697 and 13,589 in HTM and NTS versus UC at a willingness-to-pay (WTP) threshold of 20,000, and 69,100 and 83,100 at a WTP threshold of 80,000, respectively. The incremental cost-effectiveness ratios were 12,479 for HTM versus UC and 8,270 for NTS versus UC. The current scenario (including telenurse cost inputs in NTS) yielded results that were slightly different from those for the original scenario, when comparing all New York Heart Association (NYHA) classes of severity. NTS dominated HTM, compared with UC, in all NYHA classes except NYHA IV.CONCLUSIONS:
This modeling study demonstrated that HTM and NTS are viable solutions to support patients with chronic heart failure. NTS is cost-effective in comparison with UC at a WTP of 9000/QALY or higher. Like NTS, HTM improves the survival of patients in all NYHA classes and is cost-effective in comparison with UC at a WTP of 14,000/QALY or higher.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Telefone
/
Custos de Cuidados de Saúde
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Telemedicina
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Serviços Hospitalares de Assistência Domiciliar
/
Telenfermagem
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Insuficiência Cardíaca
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
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Health_economic_evaluation
/
Prognostic_studies
Limite:
Aged
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Value Health
Assunto da revista:
FARMACOLOGIA
Ano de publicação:
2018
Tipo de documento:
Article