Cost-utility analysis of remote monitoring of users with pacemakers five years after implantation
Abstract Introduction Cost-effectiveness studies on pacemakers have increased in the last years. However the number of long-term cost-utility studies is limited. The objective of this study was to perform a cost-utility analysis comparing remote monitoring (RM) versus conventional monitoring (CM) in hospital of patients with pacemakers, 5 years after implant. Methods Under a controlled, not randomized nor masked clinical trial, 82 patients with pacemaker were initially selected (CM = 52; RM = 30). Patients were monitored during 5 years, after what a total 34 for CM in hospital and 21 for RM finalised the study. A cost-utility analysis was conducted to assess cost-utility of RM in terms of costs per gained quality-adjusted life years (QALYs). Costs from National Health Service (NHS) and patient perspectives were considered. Results After 60-months of follow-up, total costs per patient were 23.02% lower in the RM than in the CM group, corresponding to a €82.10 cost saving per patient (p = 0.033). However, the reduction of in-hospital visits derived from RM does not impact significantly costs from the NHS perspective, with a cost saving of 15.04% per patient (p = 0.144). Patients in the CM group showed a slightly better QALY at the end of the study (3.579) than RM group (3.306). Costs/QALYs obtained by the RM group were higher than the CM group (p = 0.773). The incremental cost-effectiveness ratio of CM in comparison to RM becomes positive (€301.16). Conclusions This study confirms RM of patients with pacemakers appears still as a cost-effective alternative to conventional monitoring in hospital after 5 years. Key messages Total costs per patient were 23.02% lower in the Remote Monitoring than in the Conventional Monitoring group (p = 0.033). The reduction of in-hospital visits derived from Remote Monitoring does not impact significantly costs from the NHS perspective, with a cost saving of 15.04% per patient (p = 0.144).