Cost-Effectiveness Analysis of Digital Therapeutics for Home-based Cardiac Rehabilitation for Patients with Chronic Heart Failure: Model Development and Data Analysis (Preprint)

Abstract

In recent years, numerous guidelines and expert consensus have recommended the inclusion of digital technologies and products in cardiac rehabilitation. Digital Therapeutics (DTx) is based on evidence-based medicine and uses digital means for data collection and monitoring of indicators to control and optimize the treatment, management and prevention of disease.

This study aimed to conduct an early technology assessment of digital therapeutics. Based on the evaluation methods and models of health economics, we analyze the potential cost effectiveness of digital therapeutics for home-based cardiac rehabilitation for patients with chronic heart failure from the perspective of healthcare decision makers so as to provide a basis and reference for application and the promotion of digital therapeutics.

Markov models were constructed to simulate the outcomes of digital therapeutics for home-based cardiac rehabilitation (DT group) compared to conventional home-based cardiac rehabilitation (UC group) in patients with chronic heart failure. Model input parameters were clinical indicators and cost data. The outcome indicators were quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratios (ICERs). The robustness of the evaluation methods and results was tested by sensitivity analyses. Clinical indicators, cost data, and health utility values were obtained from real-world data, including clinical study data, published literature, and public website information.

The Markov model simulated a time span of 10 years with the cycle set at one month, for a total of 120 cycles. The results showed that the per capita cost of UC group was 38,442.11 RMB/year, with a QALY of 0.7196 per person per year. The per capita cost of DT group was 42,300.26 RMB/year, with a QALY of 0.81687 per person per year. The ICER per person was 39,663.5 RMB/QALY each year, which was below the willingness-to-pay threshold of 80,976 RMB (China's GDP per capita in 2021).

Digital therapeutics for home-based cardiac rehabilitation is an extremely cost-effective rehabilitation option compared to conventional home-based cardiac rehabilitation. From the perspective of health care decision makers, digital therapeutics for home-based cardiac rehabilitation is potentially valuable.