WSD results show telehealth not cost effective for chronic disease management
22 March 2013
Results from the Whole System Demonstrator Trial, one of the largest trials of telecare and telehealth ever conducted, show that telehealth does not seem to be cost effective for supporting treatment for patients with long term conditions.
The findings, published on bmj.com, follow a BMJ study published last month showing that telehealth does not improve quality of life for patients with long term conditions. This is significant because in December 2011 the UK government used preliminary results from the WSD Trial to justify launching the 3millionlives campaign to promote the use of telehealth in the UK.
Telehealth uses technology to help people with health problems live more independently at home. For example, blood pressure or blood glucose levels can be measured at home and electronically transmitted to a health professional, reducing the need for hospital visits. It is increasingly being promoted in developed countries as a means to reduce the escalating costs of managing chronic diseases for health and social services.
Many studies have forecast that health services will be unable to cope with the incidence of chronic diseases unless more cost-efficient means are found for management of patients. Telehealth has been promoted to reduce healthcare costs while improving health related quality of life, but there is very little good quality evidence on the effect of telehealth on service use and costs.
So a team of UK researchers examined the costs and cost effectiveness of telehealth compared with usual care over 12 months in 965 patients with a long term condition (heart failure, COPD or diabetes), as part of the Whole Systems Demonstrator Trial.
Of the 965 patients, 534 received telehealth equipment and support, while 431 received usual care. The results took account of costs to both health and social care systems.
The cost per quality adjusted life year (QALY) — a combined measure of quantity and quality of life — of telehealth when added to usual care was £92,000. This is well above the cost effectiveness threshold of £30,000 set by the UK National Institute for Health and Clinical Excellence (NICE). The probability of cost effectiveness was low (11%).
Even when the effects of equipment price reductions and increased working capacity of services were combined, the probability that telehealth is cost effective was only about 61%, at a threshold of £30 000 per QALY.
The authors say that the QALY gain by people using telehealth in addition to standard support and treatment was similar to those receiving usual care, and total costs for the telehealth group were higher. As such they conclude that “telehealth does not seem to be a cost effective addition to standard support and treatment.”
The full paper is published on the BMJ at: www.bmj.com/cgi/doi/10.1136/bmj.f1035
See also Chronic Disease management in Europe — going beyond
telemonitoring, by Harry Wood, Editor of MTB Europe, published in