Cost-Effectiveness Analysis of Remote Monitoring in Patients with Diabetes Type 2
Abstract
Abstract
Background: This study aimed to investigate the economic evaluation of remote monitoring of type 2 diabetic patients for controlling glycosylated hemoglobin compared to routine care for type 2 diabetics.
Methods: Economic evaluation was carried out to calculate the unit cost of the remote monitoring technology and the routine treatment for type 2 diabetics, incremental cost-effectiveness ratio, and sensitivity analysis using the key variables such as population size and cost items (in five categories of equipment and devices, building, staff, overhead costs, and consumables costs).
Results: Considering the incremental cost-effectiveness ratio in the base-case model and in comparison with routine treatment of type 2 diabetes, remote type 2 diabetes monitoring system was placed in the second quarter (more effective and affordable technology) of the graph as the most dominant alternative (RPM vs. Routine care: Total annual cost difference: -38476.477 US$ / “Unit- reduction in HbA1C” difference: 0.488). The results of the sensitivity analysis revealed that in all scenarios, RPM was dominant compared to the routine treatment (The optimum ICER: -610.128 US$ per “Unit reduction in HbA1C” for the scenario with A 10% increase in the costs of the control and intervention group).
Conclusion: Remote patient monitoring is a dominant alternative compared to routine treatment. Results indicated that remote type 2 diabetes monitoring interventions play an effective role in reducing HbA1c, which may be considered the rationale for policymakers to use this technology.
1. Logan AG, McIsaac WJ, Tisler A, Irvine MJ, Saunders A, Dunai A, et al. Mobile phone–based remote patient monitoring system for management of hypertension in diabetic patients. American journal of hypertension. 2007;20(9):942-8.
2. Organization WH. Global report on diabetes: World Health Organization; 2016.
3. Control CfD, Prevention. National diabetes statistics report, 2017. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services. 2017.
4. Fathi ahmadsaraei N, Neshat doost Ht, Manshaee Gr, Nadi Ma. The Effectiveness of Acceptance and Commitment Therapy on Quality of Life among Patients with Type 2 Diabetes. Iranian Journal of Health Education and Health Promotion. 2016;4(1):31-9.
5. Organisation WH. Diabetes action now: an initiative of the world health organization and the international diabetes federation. 2019.
6. Organization WH. Use of glycated haemoglobin (HbA1c) in diagnosis of diabetes mellitus: abbreviated report of a WHO consultation. 2011.
7. Holl F, Munteh P, Burk R, Swoboda W. Improving Access to Care in Rural Africa Through the Use of Telemedicine: Using a mHealth System as a Case Study. Studies in health technology and informatics. 2017;244:105-.
8. Vegesna A, Tran M, Angelaccio M, Arcona S. Remote patient monitoring via non-invasive digital technologies: a systematic review. Telemedicine and e-Health. 2017;23(1):3-17.
9. Chase HP, Pearson JA, Wightman C, Roberts MD, Oderberg AD, Garg SK. Modem transmission of glucose values reduces the costs and need for clinic visits. Diabetes care. 2003;26(5):1475-9.
10. Bonsignore L, Bloom N, Steinhauser K, Nichols R, Allen T, Twaddle M, et al. Evaluating the Feasibility and Acceptability of a Telehealth Program in a Rural Palliative Care Population: TapCloud for Palliative Care. Journal of pain and symptom management. 2018.
11. Yoo B-K, Kim M, Sasaki T, Hoch JS, Marcin JP. Selected use of telemedicine in intensive care units based on severity of illness improves cost-effectiveness. Telemedicine and e-Health. 2018;24(1):21-36.
12. Smith NM, Satyshur RD. Pediatric diabetes telemedicine program improves access to care for rural families: role of APRNs. Pediatric Nursing. 2016;42(6):294.
13. Noah B, Keller MS, Mosadeghi S, Stein L, Johl S, Delshad S, et al. Impact of remote patient monitoring on clinical outcomes: an updated meta-analysis of randomized controlled trials. NPJ Digital Medicine. 2018;1(1):2.
14. Wilson LS, Maeder AJ. Recent directions in telemedicine: review of trends in research and practice. Healthcare informatics research. 2015;21(4):213-22.
15. Salehi S, Olyaeemanesh A, Mobinizadeh M, Nasli-Esfahani E, Riazi H. Assessment of remote patient monitoring (RPM) systems for patients with type 2 diabetes: a systematic review and meta-analysis. Journal of Diabetes & Metabolic Disorders. 2020:1-13.
16. Warren R, Carlisle K, Mihala G, Scuffham PA. Effects of telemonitoring on glycaemic control and healthcare costs in type 2 diabetes: a randomised controlled trial. Journal of telemedicine and telecare. 2018;24(9):586-95.
17. Fountoulakis S, Papanastasiou L, Gryparis A, Markou A, Piaditis G. Impact and duration effect of telemonitoring on HbA1c, BMI and cost in insulin-treated Diabetes Mellitus patients with inadequate glycemic control: A randomized controlled study. Hormones. 2015;14(4):632-43.
18. Type of telemedicine and its benefits for patients and physicians 2018 [Available from: https://pafcoerp.com/-%D8%B3%DB%8C%D8%B3%D8%AA%D9%85-%D9%85%D8%AF%DB%8C%D8%B1%DB%8C%D8%AA-%D8%A2%D9%85%D9%88%D8%B2%D8%B4-/articleid/429/%D8%A7%D9%86%D9%88%D8%A7%D8%B9-%D9%BE%D8%B2%D8%B4%DA%A9%DB%8C-%D8%A7%D8%B2-%D8%B1%D8%A7%D9%87-%D8%AF%D9%88%D8%B1.
19. Bayliss EA, Steiner JF, Fernald DH, Crane LA, Main DS. Descriptions of barriers to self-care by persons with comorbid chronic diseases. The Annals of Family Medicine. 2003;1(1):15-
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Issue | Vol 5, No 3 (2021) | |
Section | Review Article | |
DOI | https://doi.org/10.18502/htaa.v5i3.9350 | |
Keywords | ||
Remote Patient Monitoring Diabetes Economic Evaluation |
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