PMID- 30005749
OWN - NLM
STAT- MEDLINE
DCOM- 20180806
LR  - 20180806
IS  - 1524-4733 (Electronic)
IS  - 1098-3015 (Linking)
VI  - 21
IP  - 7
DP  - 2018 Jul
TI  - Cost-Effectiveness Analysis in Telehealth: A Comparison between Home 
      Telemonitoring, Nurse Telephone Support, and Usual Care in Chronic Heart Failure 
      Management.
PG  - 772-782
LID - S1098-3015(18)30183-9 [pii]
LID - 10.1016/j.jval.2017.11.011 [doi]
AB  - 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 euro7,697 and euro13,589 in 
      HTM and NTS versus UC at a willingness-to-pay (WTP) threshold of euro20,000, and 
      euro69,100 and euro83,100 at a WTP threshold of euro80,000, respectively. The incremental 
      cost-effectiveness ratios were euro12,479 for HTM versus UC and euro8,270 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 euro9000/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 
      euro14,000/QALY or higher.
CI  - Copyright (c) 2018 International Society for Pharmacoeconomics and Outcomes 
      Research (ISPOR). Published by Elsevier Inc. All rights reserved.
FAU - Grustam, Andrija S
AU  - Grustam AS
AD  - Erasmus School of Health Policy & Management, Erasmus University Rotterdam, 
      Rotterdam, The Netherlands; Professional Health Solutions and Services 
      Department, Philips Research Europe, Eindhoven, The Netherlands. Electronic 
      address: grustam@eshpm.eur.nl.
FAU - Severens, Johan L
AU  - Severens JL
AD  - Erasmus School of Health Policy & Management, Erasmus University Rotterdam, 
      Rotterdam, The Netherlands.
FAU - De Massari, Daniele
AU  - De Massari D
AD  - Chronic Disease Management Department, Philips Research Europe, Eindhoven, The 
      Netherlands.
FAU - Buyukkaramikli, Nasuh
AU  - Buyukkaramikli N
AD  - Erasmus School of Health Policy & Management, Erasmus University Rotterdam, 
      Rotterdam, The Netherlands.
FAU - Koymans, Ron
AU  - Koymans R
AD  - Professional Health Solutions and Services Department, Philips Research Europe, 
      Eindhoven, The Netherlands.
FAU - Vrijhoef, Hubertus J M
AU  - Vrijhoef HJM
AD  - Saw Swee Hock School of Public Health, National University of Singapore, 
      Singapore; Department of Patient and Care, Maastricht UMC, Maastricht, The 
      Netherlands; Department of Family Medicine and Chronic Care, Vrije Universiteit 
      Brussels, Brussels, Belgium.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20180321
PL  - United States
TA  - Value Health
JT  - Value in health : the journal of the International Society for Pharmacoeconomics 
      and Outcomes Research
JID - 100883818
SB  - IM
MH  - Aged
MH  - Chronic Disease
MH  - Clinical Decision-Making
MH  - Cost-Benefit Analysis
MH  - Databases, Factual
MH  - Decision Support Techniques
MH  - Female
MH  - *Health Care Costs
MH  - Heart Failure/diagnosis/*economics/*therapy
MH  - Home Care Services, Hospital-Based/*economics
MH  - Humans
MH  - Insurance, Health, Reimbursement/economics
MH  - Male
MH  - Markov Chains
MH  - Models, Economic
MH  - Quality-Adjusted Life Years
MH  - Randomized Controlled Trials as Topic
MH  - Telemedicine/*economics/instrumentation/methods
MH  - Telenursing/*economics/instrumentation/methods
MH  - Telephone/*economics
MH  - Time Factors
MH  - Treatment Outcome
MH  - Uncertainty
OTO - NOTNLM
OT  - CEA
OT  - CHF
OT  - Markov model
OT  - telehealth
EDAT- 2018/07/15 06:00
MHDA- 2018/08/07 06:00
CRDT- 2018/07/15 06:00
PHST- 2016/06/26 00:00 [received]
PHST- 2017/10/31 00:00 [revised]
PHST- 2017/11/30 00:00 [accepted]
PHST- 2018/07/15 06:00 [entrez]
PHST- 2018/07/15 06:00 [pubmed]
PHST- 2018/08/07 06:00 [medline]
AID - S1098-3015(18)30183-9 [pii]
AID - 10.1016/j.jval.2017.11.011 [doi]
PST - ppublish
SO  - Value Health. 2018 Jul;21(7):772-782. doi: 10.1016/j.jval.2017.11.011. Epub 2018 
      Mar 21.