TY  - JOUR
AU  - Jiang, Xinchan
AU  - Yao, Jiaqi
AU  - You, Joyce Hoi-Sze
PY  - 2021
DA  - 2021/3/3
TI  - Cost-effectiveness of a Telemonitoring Program for Patients With Heart Failure During the COVID-19 Pandemic in Hong Kong: Model Development and Data Analysis
JO  - J Med Internet Res
SP  - e26516
VL  - 23
IS  - 3
KW  - telemonitoring
KW  - mobile health
KW  - smartphone
KW  - heart failure
KW  - COVID-19
KW  - health care avoidance
KW  - cost-effectiveness
AB  - Background: The COVID-19 pandemic has caused patients to avoid seeking medical care. Provision of telemonitoring programs in addition to usual care has demonstrated improved effectiveness in managing patients with heart failure (HF). Objective: We aimed to examine the potential clinical and health economic outcomes of a telemonitoring program for management of patients with HF during the COVID-19 pandemic from the perspective of health care providers in Hong Kong. Methods: A Markov model was designed to compare the outcomes of a care under COVID-19 (CUC) group and a telemonitoring plus CUC group (telemonitoring group) in a hypothetical cohort of older patients with HF in Hong Kong. The model outcome measures were direct medical cost, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio. Sensitivity analyses were performed to examine the model assumptions and the robustness of the base-case results. Results: In the base-case analysis, the telemonitoring group showed a higher QALY gain (1.9007) at a higher cost (US $15,888) compared to the CUC group (1.8345 QALYs at US $15,603). Adopting US $48,937/QALY (1 × the gross domestic product per capita of Hong Kong) as the willingness-to-pay threshold, telemonitoring was accepted as a highly cost-effective strategy, with an incremental cost-effective ratio of US $4292/QALY. No threshold value was identified in the deterministic sensitivity analysis. In the probabilistic sensitivity analysis, telemonitoring was accepted as cost-effective in 99.22% of 10,000 Monte Carlo simulations. Conclusions: Compared to the current outpatient care alone under the COVID-19 pandemic, the addition of telemonitoring-mediated management to the current care for patients with HF appears to be a highly cost-effective strategy from the perspective of health care providers in Hong Kong. 
SN  - 1438-8871
UR  - https://www.jmir.org/2021/3/e26516
UR  - https://doi.org/10.2196/26516
UR  - http://www.ncbi.nlm.nih.gov/pubmed/33656440
DO  - 10.2196/26516
ID  - info:doi/10.2196/26516
ER  -