Economic evaluation and costs of remote patient monitoring for cardiovascular disease in the United States: a systematic review

• Published in: International journal of technology assessment in health care 2023-04, Vol.39 (1), p.e25, Article e25
• Main Authors: Zhang, Yunxi, Peña, Maria T., Fletcher, Lauren M., Lal, Lincy, Swint, J. Michael, Reneker, Jennifer C.
• Format: Article
• Language: English
• Subjects: Assessment; Cardiovascular diseases; Cardiovascular Diseases - therapy; Cost analysis; Cost-Benefit Analysis; Delivery of Health Care; Economic analysis; Effectiveness; Evaluation; Health care expenditures; Health care policy; Heart diseases; Humans; Information sources; Intervention; Monitoring, Physiologic; Patients; Personal health; Quality assessment; Remote monitoring; Sustainability; Systematic review; Telemedicine; Treatment Outcome; United States
• ISSN: 0266-4623; 1471-6348; 1471-6348
• DOI: 10.1017/S0266462323000156

Remote patient monitoring (RPM) has emerged as a viable and valuable care delivery method to improve chronic disease management. In light of the high prevalence and substantial economic burden of cardiovascular disease (CVD), this systematic review examines the cost and cost-effectiveness of using RPM to manage CVD in the United States. We systematically searched databases to identify potentially relevant research. Findings were synthesized for cost and cost-effectiveness by economic study type with consideration of study perspective, intervention, clinical outcome, and time horizon. The methodological quality was assessed using the Joanna Briggs Institute Checklist for Economic Evaluations. Thirteen articles with fourteen studies published between 2011 and 2021 were included in the final review. Studies from the provider perspective with a narrow scope of cost components identified higher costs and similar effectiveness for the RPM group relative to the usual care group. However, studies from payer and healthcare sector perspectives indicate better clinical effectiveness of RPM relative to usual care, with two cost-utility analysis studies suggesting that RPM relative to usual care is a cost-effective tool for CVD management even at the conservative $50,000 per Quality-Adjusted Life-Year threshold. Additionally, all model-based studies revealed that RPM is cost-effective in the long run. Full economic evaluations identified RPM as a potentially cost-effective tool, particularly for long-term CVD management. In addition to the current literature, rigorous economic analysis with a broader perspective is needed in evaluating the value and economic sustainability of RPM.