Καρδιακή ανεπάρκεια και τηλεπαρακολούθηση : μια ανάλυση κόστους - αποτελεσματικότητας
Heart failure and telemonitoring : a cost-effectiveness analysis
KeywordsΑπομακρυσμένη παρακολούθηση ασθενών ; Διαχείριση νόσου ; Ανάλυση κόστους - αποτελεσματικότητας ; Heart failure ; Remote patient monitoring ; Disease management ; Cost efficiency analysis
Heart failure is a disease that affects a great proportion of the world's population with such increasing trends over time that could well be described as a pandemic. The adverse economic impact of the disease on health systems results in the use of a significant amount of society’s scarce resources. The development of technological innovations attempts to reduce the cost associated with the management of the disease. One of the most recent recommendations is to implement remote monitoring in patients with heart failure. In the area of remote monitoring technologies various strategies have been developed. This study attempts to assess the cost-effectiveness of telemonitoring versus usual care in heart failure patients in Greece. The analysis uses a Markov model applied to a Greek hypothetical population with heart failure. The study population consists of patients diagnosed with heart failure, aged 65 years, who have been hospitalised due to heart failure and have been discharged within the previous 28 days. The intervention group received telemonitoring while the control group received usual care. The duration of analysis was 35 years by the end of which all patients had died. The analysis resulted in an estimated cost and effectiveness of €50,133 per patient and 2.98 QALYs respectively for the intervention group and €25,154 per patient and 2.29 QALYs for the control group. The incremental cost-effectiveness ratio (ICER) was thus estimated at €35,828/QALY over lifetime, an estimate which decision makers might find acceptable. A range of sensitivity analyses showed that varying the values of a set of parameters did not change the results of the basecase analysis significantly. In conclusion, the findings of this analysis indicate that telemonitoring of patients with heart failure might be viewed as the recommended monitoring strategy in these patients compared to usual care based on clinical effectiveness and cost-effectivenes.