The Development of a Microsimulation Model to Evaluate the Cost-utility of Telemonitoring for Patients with Heart Failure in Ontario, Canada

Objective: To assess the cost-utility of telemonitoring compared to the current standard of care in the management of patients with heart failure over a 25-year time horizon from a public payer perspective. Methods: A microsimulation model was developed to analyze telemonitoring’s cost-utility by using data from the Medly Program Evaluation and literature. Scenario analyses were conducted in relation to HF severity and TM deployment models. A probabilistic sensitivity analysis (PSA) and one-way analyses were performed. Results: TM had an incremental cost of $16,478 and incremental Quality-Adjusted Life Year (QALY) of 0.671 resulting in ICER of$24,553/QALY. PSA showed 84.4% likelihood of cost-effectiveness under $50,000/QALY willingness-to-pay. Scenario analyses did not show significant changes to ICERs. Results were sensitive to the reduction of hospitalizations by TM. Conclusion: The model demonstrates that TM is cost-effective compared to current standard of care. This study could be repeated when more follow up data becomes available.M.Sc