Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2007 Jul 27:5:10.
doi: 10.1186/1478-7547-5-10.

Cost-effectiveness of a nurse-led telemonitoring intervention based on peak expiratory flow measurements in asthmatics: results of a randomised controlled trial

Daniëlle C M Willems  1 , Manuela A Joore, Johannes J E Hendriks, Emiel F M Wouters, Johan L Severens
Affiliations

Cost-effectiveness of a nurse-led telemonitoring intervention based on peak expiratory flow measurements in asthmatics: results of a randomised controlled trial

Daniëlle C M Willems et al. Cost Eff Resour Alloc. .

Abstract

Background: Asthma is a chronic lung disease in which recurrent asthma symptoms create a substantial burden to individuals and their families. At the same time the economic burden associated with asthma is considerable.

Methods: The cost-effectiveness study was part of a single centre prospective randomised controlled trial comparing a nurse-led telemonitoring programme to usual care in a population of asthmatic outpatients. The study included 109 asthmatic outpatients (56 children; 53 adults). The duration of follow-up was 12 months, and measurements were performed at baseline, 4, 8, and 12 months. Patients were asked to transfer their monitor data at least twice daily and by judging the received data and following a stepwise intervention protocol a nurse was able to act as the main caregiver in the intervention group. In both groups the EQ-5D and the SF-6D were used to obtain estimates of health state utilities. One year health care costs, patient and family costs, and productivity losses were calculated. The mean incremental costs were weighted against the mean incremental effect in terms of QALY.

Results: The study population generally represented mild to moderate asthmatics. No significant differences were found between the groups with regard to the generic quality of life. Overall, the mean health care costs per patient were higher in the intervention group than in the control group. The intervention costs mainly caused the cost difference between the groups. The intervention costs the society euro 31,035/QALY gained with regard to adults and with regard to children euro 59,071/QALY gained.

Conclusion: If the outcome is measured by generic quality of life the nurse-led telemonitoring programme is of limited cost-effectiveness in the study population. From the societal perspective the probability of the programme being cost-effective compared to regular care was 85% at a ceiling ratio of euro 80,000/QALY gained among the adults and 68% among the children. A decrease in the price of the asthma monitor will substantial increase the probability of the programme to be cost-effective.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Cost-effectiveness plane from a societal perspective with EQ-5D utility for adults.
Figure 2
Figure 2
Cost-effectiveness acceptability curves (base case and minus the asthma monitor costs) from a societal perspective with EQ-5D utility for adults.
Figure 3
Figure 3
Cost-effectiveness plane from a societal perspective with EQ-5D utility for children.
Figure 4
Figure 4
Cost-effectiveness acceptability curves (base case and minus the asthma monitor costs) from a societal perspective with EQ-5D utility for children.
Figure 5
Figure 5
Cost-effectiveness plane from a societal perspective with SF-6D utility for adults.
Figure 6
Figure 6
Cost-effectiveness acceptability curves (base case and minus the asthma monitor costs) from a societal perspective with SF-6D utility for adults.
See this image and copyright information in PMC

References

    1. World Health Organization (WHO) Bronchial asthma: The scale of the problem http://www.who.int/mediacentre/factsheets/fs206/en/
    1. Masoli M, Fabian D, Holt S, Beasley R. Global Initiative for Asthma (GINA): global burden of asthma http://www.ginasthma.com/ReportItem.asp?l1=2&l2=2&intId=94 - PubMed
    1. Hoogendoorn M, Feenstra TL, Rutten-van Mölken MPMH. Projections of future resource use and the costs of asthma and COPD in the Netherlands (in Dutch) Ned Tijdschr Geneeskd. 2006;150:1243–50. - PubMed
    1. Cisternas MG, Blanc PD, Yen IH, Katz PP, Earnest G, Eisner MD, Shiboski S, Yelin EH. A comprehensive study of the direct and indirect costs of adult asthma. J Allergy Clin Immunol. 2003;111:1212–1218. doi: 10.1067/mai.2003.1449. - DOI - PubMed
    1. Drummond MF, Sculpher MJ, Torrance GW, O'Brien BJ, Stoddart GL. Methods for the economic evaluation of health care programmes. Third. Oxford: Oxford University Press; 2005.

LinkOut - more resources