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Outcomes and costs of remote patient monitoring among patients with implanted cardiac defibrillators: An economic model based on the PREDICT RM database

Hummel, James P. ; Leipold, Robert J. ; Amorosi, Stacey L. ; Bao, Haikun ; Deger, Kristen A. ; Jones, Paul W. ; Kansal, Anuraag R. ; Ott, Lesli S. ; Stern, Sean ; Stein, Kenneth ; Curtis, Jeptha P. ; Akar, Joseph G.

Journal of cardiovascular electrophysiology, 2019-07, Vol.30 (7), p.1066-1077 [Periódico revisado por pares]

United States: Wiley Subscription Services, Inc

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Título:
Outcomes and costs of remote patient monitoring among patients with implanted cardiac defibrillators: An economic model based on the PREDICT RM database
Autor: Hummel, James P. ; Leipold, Robert J. ; Amorosi, Stacey L. ; Bao, Haikun ; Deger, Kristen A. ; Jones, Paul W. ; Kansal, Anuraag R. ; Ott, Lesli S. ; Stern, Sean ; Stein, Kenneth ; Curtis, Jeptha P. ; Akar, Joseph G.
Assuntos: Aged ; Aged, 80 and over ; Arrhythmias, Cardiac - diagnosis ; Arrhythmias, Cardiac - economics ; Arrhythmias, Cardiac - mortality ; Arrhythmias, Cardiac - therapy ; Cost-Benefit Analysis ; Costs ; cost‐effectiveness ; Databases, Factual ; Death, Sudden, Cardiac - prevention & control ; Defibrillators ; Defibrillators, Implantable - economics ; Economic models ; Electric Countershock - adverse effects ; Electric Countershock - economics ; Electric Countershock - instrumentation ; Electric Countershock - mortality ; Female ; Health Care Costs ; Humans ; implantable cardioverter‐defibrillators ; Life span ; Male ; Medicare - economics ; Models, Economic ; Monitoring ; Mortality ; Original ; Patient Readmission - economics ; Patients ; Predictive Value of Tests ; Quality-Adjusted Life Years ; Registries ; remote monitoring ; Remote Sensing Technology - economics ; Remote Sensing Technology - instrumentation ; Telemetry - economics ; Telemetry - instrumentation ; Time Factors ; Treatment Outcome ; United States
É parte de: Journal of cardiovascular electrophysiology, 2019-07, Vol.30 (7), p.1066-1077
Notas: Stacey Amorosi, Paul Jones, and Kenneth Stein are paid employees of Boston Scientific Corporation. Robert Leipold, Kirsten Deger, Anuraag Kansal, and Sean Stern are currently, or were at the time of the study, employees of Evidera, a paid consultant to Boston Scientific. James Hummel, Haikun Bao, Lesli Ott, Jeptha Curtis, and Joseph Akar have no disclosures.
Disclosures
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Disclosures: Stacey Amorosi, Paul Jones, and Kenneth Stein are paid employees of Boston Scientific Corporation. Robert Leipold, Kirsten Deger, Anuraag Kansal, and Sean Stern are currently, or were at the time of the study, employees of Evidera, a paid consultant to Boston Scientific. James Hummel, Haikun Bao, Lesli Ott, Jeptha Curtis, and Joseph Akar have no disclosures.
Descrição: Background Remote monitoring of implantable cardioverter‐defibrillators has been associated with reduced rates of all‐cause rehospitalizations and mortality among device recipients, but long‐term economic benefits have not been studied. Methods and Results An economic model was developed using the PREDICT RM database comparing outcomes with and without remote monitoring. The database included patients ages 65 to 89 who received a Boston Scientific device from 2006 to 2010. Parametric survival equations were derived for rehospitalization and mortality to predict outcomes over a maximum time horizon of 25 years. The analysis assessed rehospitalization, mortality, and the cost‐effectiveness (expressed as the incremental cost per quality‐adjusted life year) of remote monitoring versus no remote monitoring. Remote monitoring was associated with reduced mortality; average life expectancy and average quality‐adjusted life years increased by 0.77 years and 0.64, respectively (6.85 life years and 5.65 quality‐adjusted life years). When expressed per patient‐year, remote monitoring patients had fewer subsequent rehospitalizations (by 0.08 per patient‐year) and lower hospitalization costs (by $554 per patient year). With longer life expectancies, remote monitoring patients experienced an average of 0.64 additional subsequent rehospitalizations with increased average lifetime hospitalization costs of $2784. Total costs of outpatient and physician claims were higher with remote monitoring ($47 515 vs $42 792), but average per patient‐year costs were lower ($6232 vs $6244). The base‐case incremental cost‐effectiveness ratio was $10 752 per quality‐adjusted life year, making remote monitoring high‐value care. Conclusion Remote monitoring is a cost‐effective approach for the lifetime management of patients with implantable cardioverter‐defibrillators.
Editor: United States: Wiley Subscription Services, Inc
Idioma: Inglês

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Outcomes and costs of remote patient monitoring among patients with implanted cardiac defibrillators: An economic model based on the PREDICT RM database

Hummel, James P. ; Leipold, Robert J. ; Amorosi, Stacey L. ; Bao, Haikun ; Deger, Kristen A. ; Jones, Paul W. ; Kansal, Anuraag R. ; Ott, Lesli S. ; Stern, Sean ; Stein, Kenneth ; Curtis, Jeptha P. ; Akar, Joseph G.

United States: Wiley Subscription Services, Inc

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