Telemonitoring for chronic obstructive pulmonary disease: a cost and cost-utility analysis of a randomised controlled trial

Andrew Stoddart*, Marjon van der Pol, Hilary Pinnock, Janet Hanley, Lucy McCloughan, Allison Todd, Ashma Krishan, Brian McKinstry

*Corresponding author for this work

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

We compared the costs and cost-effectiveness of telemonitoring vs usual care for patients with chronic obstructive pulmonary disease (COPD). A total of 256 patients were randomised to either telemonitoring or usual care. In the telemonitoring arm, the touch-screen telemonitoring equipment transmitted data to clinical teams monitoring the patients. Total healthcare costs were estimated over a 12-month period from a National Health Service perspective and quality adjusted life year (QALYs) were estimated by the EQ-5D tool. Telemonitoring was not significantly more costly than usual care (mean difference per patient £2065.90 (P < 0.18). The increased costs were predominantly due to telemonitoring service costs and non-significantly higher secondary care costs. Telemonitoring for COPD was not cost-effective at a base case of £137,277 per QALY with only 15% probability of being cost-effective at the usual threshold of £30,000 per QALY. Although there was some statistical and methodological uncertainty in the measures used, telemonitoring was not cost-effective in the sensitivity analyses performed. It seems unlikely that a telemonitoring service of the kind that was trialled would be cost-effective in providing care for people with COPD.

Original languageEnglish
Pages (from-to)108-118
Number of pages11
JournalJournal of telemedicine and telecare
Volume21
Issue number2
Early online date13 Jan 2015
DOIs
Publication statusPublished - 1 Mar 2015

Keywords

  • whole systems demonstrator
  • global burden
  • telehealth
  • care
  • exacerbation
  • mortality
  • program
  • COPD

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