A study published on bmj.com suggests that telehealth may not be a cost-effective addition to standard support and treatment for patients with long-term conditions.
A team of UK researchers examined the costs and cost-effectiveness of telehealth compared with usual care over 12 months, in 965 patients with a long-term condition (heart failure, chronic obstructive pulmonary disease or diabetes). The study is part of the Whole Systems Demonstrator Trial – one of the largest and most comprehensive investigations of telehealth and telecare ever conducted. Of the 965 patients, 534 received telehealth equipment and support, while 431 received usual care. The results took account of costs to both health and social care systems. The cost per quality adjusted life year (QALY) – a combined measure of quantity and quality of life – of telehealth when added to usual care was £92,000. This is well above the cost effectiveness threshold of £30,000 set by NICE. The probability of cost-effectiveness was low (11%). Even when the effects of equipment price reductions and increased working capacity of services were combined, the probability that telehealth is cost-effective was only about 61%, at a threshold of £30,000 per QALY. The authors said that the QALY gain by people using telehealth in addition to standard support and treatment was similar to those receiving usual care, and total costs for the telehealth group were higher. As such they concluded that “telehealth does not seem to be a cost-effective addition to standard support and treatment.”
