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Cost-Utility Analysis of Telemonitoring Interventions for Patients with Chronic Obstructive Pulmonary Disease (COPD) in Germany

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Abstract

Background

Chronic obstructive pulmonary disease (COPD) poses major challenges for health care systems. Previous studies suggest that telemonitoring could be effective in preventing hospitalisations and hence reduce costs.

Objective

The aim was to evaluate whether telemonitoring interventions for COPD are cost-effective from the perspective of German statutory sickness funds.

Methods

A cost-utility analysis was conducted using a combination of a Markov model and a decision tree. Telemonitoring as add-on to standard treatment was compared with standard treatment alone. The model consisted of four transition stages to account for COPD severity, and a terminal stage for death. Within each cycle, the frequency of exacerbations as well as outcomes for 2015 costs and quality adjusted life years (QALYs) for each stage were calculated. Values for input parameters were taken from the literature. Deterministic and probabilistic sensitivity analyses were conducted.

Results

In the base case, telemonitoring led to an increase in incremental costs (€866 per patient) but also in incremental QALYs (0.05 per patient). The incremental cost-effectiveness ratio (ICER) was thus €17,410 per QALY gained. A deterministic sensitivity analysis showed that hospitalisation rate and costs for telemonitoring equipment greatly affected results. The probabilistic ICER averaged €34,432 per QALY (95 % confidence interval 12,161–56,703).

Conclusion

We provide evidence that telemonitoring may be cost-effective in Germany from a payer’s point of view. This holds even after deterministic and probabilistic sensitivity analyses.

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Notes

  1. Results depended on the survey technique that was used.

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Authors and Affiliations

  1. Hamburg Center for Health Economics (HCHE), Universität Hamburg, Esplanade 36, 20354, Hamburg, Germany

    Florian Hofer, Dmitrij Achelrod & Tom Stargardt

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  1. Florian Hofer
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  2. Dmitrij Achelrod
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  3. Tom Stargardt
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Correspondence to Florian Hofer.

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Author contributions

FH contributed to the study design, statistical analysis, interpretation of the results, synthesis, and drafting of the manuscript. DA contributed to statistical analysis, interpretation of the results, and critical revision of the manuscript. TS contributed to statistical analysis, interpretation of the results, and critical revision of the manuscript. FH takes responsibility for accuracy of the data analysis and integrity of the data analysis.

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This study has not received any funding.

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Florian Hofer, Dmitrij Achelrod, and Tom Stargardt declare that they have no conflicts of interest.

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Hofer, F., Achelrod, D. & Stargardt, T. Cost-Utility Analysis of Telemonitoring Interventions for Patients with Chronic Obstructive Pulmonary Disease (COPD) in Germany. Appl Health Econ Health Policy 14, 691–701 (2016). https://doi.org/10.1007/s40258-016-0267-9

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