Cost effectiveness analysis of out-patient and remote monitoring of patients after pacemaker replacement from the perspective of the health care payer

Abstract

ObjectivesTo determine the cost effectiveness of remote vs. outpatient monitoring of patients with pacemaker after device replacement due to battery depletion. BackgroundDespite the fact that modern pacemakers can be checked remotely, most check-ups are still carried out during outpatient visits. So far, a cost effectiveness analysis of remote monitoring has not been performed in the Czech Republic. Patients, methodsA retrospective analysis was done using the files of 217 patients that had undergone pacemaker replacement between 2002 and 2005. All visits from 2002 to 2015 were analyzed. Using a pharmacoeconomic model, a cost minimization analysis was made to compare the costs of outpatient visits relative to remote monitoring of pacemakers, from the perspective of the health care payer. ResultsThe costs for the out-patient follow-up of the analyzed group of patients were calculated to be 802,709CZK. Remote management for the same group would have cost 6,398,631CZK. Cost minimization analysis showed that remote monitoring would have cost 5,595,922CZK more than current standard care. ConclusionRemote monitoring, is from the perspective of the health care payer, not associated with costs reduction in patients after pacemaker replacement due to battery depletion compared to standard out-patient follow-up.