PMID- 31538948 OWN - NLM STAT- MEDLINE DCOM- 20200520 LR - 20200520 IS - 1438-8871 (Electronic) IS - 1439-4456 (Print) IS - 1438-8871 (Linking) VI - 21 IP - 9 DP - 2019 Sep 13 TI - Telemonitoring of Crohn's Disease and Ulcerative Colitis (TECCU): Cost-Effectiveness Analysis. PG - e15505 LID - 10.2196/15505 [doi] LID - e15505 AB - BACKGROUND: Although electronic health interventions are considered safe and efficient, evidence regarding the cost-effectiveness of telemonitoring in inflammatory bowel disease is lacking. OBJECTIVE: We aimed to evaluate the cost-effectiveness and cost-utility of the Telemonitorizacion de la Enfermedad de Crohn y Colitis Ulcerosa (Telemonitoring of Crohn's Disease and Ulcerative Colitis [TECCU]) Web platform (G_TECCU intervention group) for telemonitoring complex inflammatory bowel disease, compared with standard care (G_control) and nurse-assisted telephone care (G_NT intervention group). METHODS: We analyzed cost-effectiveness from a societal perspective by comparing the 3 follow-up methods used in a previous 24-week randomized controlled trial, conducted at a tertiary university hospital in Spain. Patients with inflammatory bowel disease who initiated immunosuppressants or biologic agents, or both, to control inflammatory activity were recruited consecutively. Data on the effects on disease activity (using clinical indexes) and quality-adjusted life-years (using the EuroQol 5 dimensions questionnaire) were collected. We calculated the costs of health care, equipment, and patients' productivity and social activity impairment. We compared the mean costs per patient, utilities, and bootstrapped differences. RESULTS: We included 63 patients (21 patients per group). TECCU saved euro1005 (US $1100) per additional patient in remission compared with G_control (95% CI euro-13,518 to 3137; US $-14,798 to 3434), with a 79.96% probability of being more effective at lower costs. Compared with G_NT, TECCU saved euro2250 (US $2463) per additional patient in remission (95% CI euro-15,363 to 11,086; US $-16,817 to 12,135), and G_NT saved euro538 (US $589) compared with G_control (95% CI euro-6475 to 5303; US $-7088 to 5805). G_TECCU and G_NT showed an 84% and 67% probability, respectively, of producing a cost saving per additional quality-adjusted life-year (QALY) compared with G_control, considering those simulations that involved negative incremental QALYs as well. CONCLUSIONS: There is a high probability that the TECCU Web platform is more cost-effective than standard and telephone care in the short term. Further research considering larger cohorts and longer time horizons is required. TRIAL REGISTRATION: ClinicalTrials.gov NCT02943538; https://clinicaltrials.gov/ct2/show/NCT02943538 (http://www. webcitation.org/746CRRtDN). CI - (c)Javier Del Hoyo, Pilar Nos, Guillermo Bastida, Raquel Faubel, Diana Munoz, Alejandro Garrido-Marin, Elena Valero-Perez, Sergio Bejar-Serrano, Mariam Aguas. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 13.09.2019. FAU - Del Hoyo, Javier AU - Del Hoyo J AUID- ORCID: 0000-0003-3603-5793 AD - Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain. FAU - Nos, Pilar AU - Nos P AUID- ORCID: 0000-0002-6619-1511 AD - Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain. AD - Networked Biomedical Research Center for Hepatic and Digestive Diseases, Valencia, Spain. AD - Health Research Institute La Fe, Valencia, Spain. FAU - Bastida, Guillermo AU - Bastida G AUID- ORCID: 0000-0001-7544-451X AD - Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain. AD - Networked Biomedical Research Center for Hepatic and Digestive Diseases, Valencia, Spain. AD - Health Research Institute La Fe, Valencia, Spain. FAU - Faubel, Raquel AU - Faubel R AUID- ORCID: 0000-0002-8716-8003 AD - Physiotherapy Department, University of Valencia, Valencia, Spain. AD - Joint Research Unit in Biomedical Engineering-eRPSS, Health Research Institute La Fe-Polytechnic University of Valencia, Valencia, Spain. FAU - Munoz, Diana AU - Munoz D AUID- ORCID: 0000-0003-0723-7927 AD - Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain. FAU - Garrido-Marin, Alejandro AU - Garrido-Marin A AUID- ORCID: 0000-0003-1299-9010 AD - Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain. FAU - Valero-Perez, Elena AU - Valero-Perez E AUID- ORCID: 0000-0003-1215-7411 AD - Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain. FAU - Bejar-Serrano, Sergio AU - Bejar-Serrano S AUID- ORCID: 0000-0002-1441-9975 AD - Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain. FAU - Aguas, Mariam AU - Aguas M AUID- ORCID: 0000-0003-4353-569X AD - Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain. AD - Networked Biomedical Research Center for Hepatic and Digestive Diseases, Valencia, Spain. AD - Health Research Institute La Fe, Valencia, Spain. LA - eng SI - ClinicalTrials.gov/NCT02943538 PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20190913 PL - Canada TA - J Med Internet Res JT - Journal of medical Internet research JID - 100959882 SB - IM MH - Adult MH - Colitis, Ulcerative/*economics/*epidemiology MH - Cost-Benefit Analysis/*methods MH - Crohn Disease/*economics/*epidemiology MH - Female MH - Humans MH - Male MH - Middle Aged MH - Telemedicine/*methods MH - Young Adult PMC - PMC6754696 OTO - NOTNLM OT - Crohn disease OT - colitis, ulcerative OT - cost-effectiveness OT - eHealth OT - inflammatory bowel diseases OT - telemedicine COIS- Conflicts of Interest: None declared. EDAT- 2019/09/21 06:00 MHDA- 2020/05/21 06:00 PMCR- 2019/09/13 CRDT- 2019/09/21 06:00 PHST- 2019/07/20 00:00 [received] PHST- 2019/08/21 00:00 [accepted] PHST- 2019/08/19 00:00 [revised] PHST- 2019/09/21 06:00 [entrez] PHST- 2019/09/21 06:00 [pubmed] PHST- 2020/05/21 06:00 [medline] PHST- 2019/09/13 00:00 [pmc-release] AID - v21i9e15505 [pii] AID - 10.2196/15505 [doi] PST - epublish SO - J Med Internet Res. 2019 Sep 13;21(9):e15505. doi: 10.2196/15505.