JMIR Publications

ABSTRACT

Background:

Although eHealth interventions are considered safe and efficient, evidence regarding the cost-effectiveness of telemonitoring in inflammatory bowel disease (IBD) is lacking.

Objective:

We aimed to evaluate the cost-effectiveness and cost-utility of the TECCU Web platform (G_TECCU) for telemonitoring complex IBD, compared with standard care (G_Control) and nurse-assisted telephone care (G_NT).

Methods:

We performed a cost-effectiveness analysis from a societal perspective, comparing the 3 follow-up methods in a 24-week randomized controlled trial, conducted at a tertiary university hospital in Spain. IBD patients who initiated immunosuppressants and/or biological agents to control inflammatory activity were recruited consecutively. The effects on disease activity (using clinical indexes) and the quality-adjusted life-years (QALYs; using the EuroQol-5D) were collected. We calculated costs of healthcare, equipment and patients´ productivity and social activity impairment. The mean costs per-patient, utilities and bootstrapped differences were compared.

Results:

Sixty-three patients were included (21 patients/group). TECCU saved -1005€ per additional patient in remission compared to G_control (95% CI, -8823 to 17230€), with a 79.96% probability of being more effective at lower costs. Compared with G_NT, TECCU saved -2250€/additional patient in remission (95% CI, -4280 to 3905), whereas G_NT saved -538€ compared to G_control (95% CI -6475 to 5303). Regarding QALYs, G_TECCU and G_NT showed an 84% and 67% probability, respectively, of producing a cost-saving per additional QALY compared with G_control, considering those simulations that involved negative incremental QALYs as well.

Conclusions:

There is a high probability that 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. Clinical Trial: ClinicalTrials.gov NCT02943538