Information and Communications Technology (ICT)-based Monitoring Service for Tailored Chronic Disease Management in Primary Care: Cost-Effectiveness Analysis based on ICT-CM Trial Results (Preprint)

Abstract

Information and communications technology (ICT)-based tailored management (TM) intervention is a novel automatic system in which smartphone application for management of hypertensive and diabetic patients, the provider web, and Bluetooth devices are linked. However, little evidence exists regarding the cost-effectiveness of the interventions using mobile application.

This study aimed to assess the cost-effectiveness of TM intervention for adult patients with hypertension or diabetes in primary care compared with usual care (UC).

Cost-effectiveness analysis using a Markov model was conducted from the Korean healthcare system perspective. Based on 6-month outcome data from an ICT-based tailored chronic disease management (ICT-CM) trial, effectiveness over a lifetime beyond the trial periods was extrapolated using a cardiovascular disease risk prediction model. Costs were estimated using ICT-CM trial data and national health insurance claims data. Health utility weights were obtained from the Korea National Health and Nutrition Examination Survey.

In the base-case analysis, compared with UC, TM was more costly ($23,157 for TM vs. $22,391 for UC) and more effective (12.006 quality-adjusted life-years [QALYs] for TM vs. 11.868 QALYs for UC). The incremental cost-effectiveness ratio (ICER) was $5556 per QALY gained. Probabilistic sensitivity analysis showed that the probability of TM being cost-effective compared with UC was approximately 97% at an ICER threshold of $26,515 (KRW 35 million) per QALY gained.

Compared with UC, TM intervention is a cost-effective option for hypertensive or diabetic patients in primary care settings. The study results can assist policymakers in making evidence-based decision when implementing accessible chronic disease management services.