@Article{info:doi/10.2196/15505,
author="Del Hoyo, Javier
and Nos, Pilar
and Bastida, Guillermo
and Faubel, Raquel
and Mu{\~{n}}oz, Diana
and Garrido-Mar{\'i}n, Alejandro
and Valero-P{\'e}rez, Elena
and Bejar-Serrano, Sergio
and Aguas, Mariam",
title="Telemonitoring of Crohn's Disease and Ulcerative Colitis (TECCU): Cost-Effectiveness Analysis",
journal="J Med Internet Res",
year="2019",
month="Sep",
day="13",
volume="21",
number="9",
pages="e15505",
keywords="telemedicine; eHealth; cost-effectiveness; inflammatory bowel diseases; Crohn disease; colitis, ulcerative",
abstract="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 Telemonitorizaci{\'o}n 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 {\texteuro}1005 (US {\$}1100) per additional patient in remission compared with G{\_}control (95{\%} CI {\texteuro}--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 {\texteuro}2250 (US {\$}2463) per additional patient in remission (95{\%} CI {\texteuro}--15,363 to 11,086; US {\$}--16,817 to 12,135), and G{\_}NT saved {\texteuro}538 (US {\$}589) compared with G{\_}control (95{\%} CI {\texteuro}--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) ",
issn="1438-8871",
doi="10.2196/15505",
url="http://www.jmir.org/2019/9/e15505/",
url="https://doi.org/10.2196/15505",
url="http://www.ncbi.nlm.nih.gov/pubmed/31538948"
}