Abstract
Objectives
Health-economic analyses of disease management programs (DMP) for chronic heart failure (CHF) with and without telemedicine have been conducted with considerable variations. HerzMobil Tirol is a 3-month transitional, telemedical assisted, post-discharge DMP (DMP-HMT) for CHF implemented in routine care in Tyrol/Austria. Our study aimed to assess effectiveness and cost effectiveness of the DMP-HMT.
Methods
We conducted a cost-effectiveness analysis along a retrospective cohort study for DMP-HMT with a propensity-score matched cohort (257 individuals usual care (UC), 251 DMP-HMT) and, one-year follow up (2016-2019). We determined the effectiveness (hospital-free life expectancy, life expectancy, and number of avoided rehospitalizations), costs (DMP, rehospitalizations) and the incremental cost-effectiveness ratio (ICER). Data preparation included two steps: missing value imputation and adjustment for remaining confounding due to imperfect matching. We performed a nonparametric sensitivity analysis with bootstrap sampling (n=5,000 replications), a sensitivity analysis on costs of CHF-rehospitalizations after events that are highly irrelevant for the stated research question and on costs per disease-related diagnosis (DRG) score for rehospitalizations.
Results
Free days, 40 additional life days, and 0.12 avoided hospitalizations per person compared to UC. The average DMP costs are 1,916 EUR/person. Mean rehospitalization costs are 5,551 EUR in DMP-HMT and 6,943 EUR in UC. The ICER of DMP-HMT compared to UC is 4,773 EUR/life-year gained outside the hospital. DMP-HMT was cost saving when "high irrelevant costs” were replaced with average costs.
Conclusions
Our economic evaluation showed that the DMP HerzMobil Tirol is cost effective compared to UC based on the one-year time follow-up horizon. The DMP was cost-saving in a sensitivity analysis correcting for "high irrelevant costs". Our findings promote a widespread adoption of telemedical assisted DMP for CHF. Further long-term assessment using a decision-analytic model is needed considering upcoming real-world evidence.
Health-economic analyses of disease management programs (DMP) for chronic heart failure (CHF) with and without telemedicine have been conducted with considerable variations. HerzMobil Tirol is a 3-month transitional, telemedical assisted, post-discharge DMP (DMP-HMT) for CHF implemented in routine care in Tyrol/Austria. Our study aimed to assess effectiveness and cost effectiveness of the DMP-HMT.
Methods
We conducted a cost-effectiveness analysis along a retrospective cohort study for DMP-HMT with a propensity-score matched cohort (257 individuals usual care (UC), 251 DMP-HMT) and, one-year follow up (2016-2019). We determined the effectiveness (hospital-free life expectancy, life expectancy, and number of avoided rehospitalizations), costs (DMP, rehospitalizations) and the incremental cost-effectiveness ratio (ICER). Data preparation included two steps: missing value imputation and adjustment for remaining confounding due to imperfect matching. We performed a nonparametric sensitivity analysis with bootstrap sampling (n=5,000 replications), a sensitivity analysis on costs of CHF-rehospitalizations after events that are highly irrelevant for the stated research question and on costs per disease-related diagnosis (DRG) score for rehospitalizations.
Results
Free days, 40 additional life days, and 0.12 avoided hospitalizations per person compared to UC. The average DMP costs are 1,916 EUR/person. Mean rehospitalization costs are 5,551 EUR in DMP-HMT and 6,943 EUR in UC. The ICER of DMP-HMT compared to UC is 4,773 EUR/life-year gained outside the hospital. DMP-HMT was cost saving when "high irrelevant costs” were replaced with average costs.
Conclusions
Our economic evaluation showed that the DMP HerzMobil Tirol is cost effective compared to UC based on the one-year time follow-up horizon. The DMP was cost-saving in a sensitivity analysis correcting for "high irrelevant costs". Our findings promote a widespread adoption of telemedical assisted DMP for CHF. Further long-term assessment using a decision-analytic model is needed considering upcoming real-world evidence.
| Originalsprache | Englisch |
|---|---|
| Seiten | S109-S110 |
| Seitenumfang | 2 |
| DOIs | |
| Publikationsstatus | Veröffentlicht - Dez. 2023 |
| Veranstaltung | ISPOR Europe 2023 - Bella Center Copenhagen, Copenhagen, Dänemark Dauer: 11 Nov. 2023 → 15 Nov. 2023 https://www.ispor.org/conferences-education/conferences/past-conferences/ispor-europe-2023 |
Konferenz
| Konferenz | ISPOR Europe 2023 |
|---|---|
| Land/Gebiet | Dänemark |
| Stadt | Copenhagen |
| Zeitraum | 11/11/23 → 15/11/23 |
| Internetadresse |
Research Field
- Exploration of Digital Health
UN SDGs
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