Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jul 20, 2019
Open Peer Review Period: Jul 22, 2019 - Jul 29, 2019
Date Accepted: Aug 21, 2019
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The cost-effectiveness of telemonitoring complex inflammatory bowel disease using the web-based telemanagement system TECCU
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 (95% CI, -4280 to 3905), whereas G_NT saved -538€ compared to G_control (95% CI -6475 to 5303). QALYs improved less in G_TECCU and G_NT, yet these interventions showed 84% and 67% probability, respectively, of being cost-saving per additional QALY compared with G_control.
Conclusions:
TECCU web platform is probably 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
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