Table 4.
Summary of findings.
| Author (published year) | Intervention | Type of intervention | Cost measurement (incremental cost) | Consequence measurement (incremental effect) | ICER | Key findings (main conclusion) |
|---|---|---|---|---|---|---|
| Bahrainwala et al. (2020) (15) | Drone Observed Therapy System (DrOTS) intervention inludes: (i) drones to deliver sputum samples and tuberculosis (TB) medication; (ii) GeneXpert™ MTB/RIF (Cepheid, Sunnyvale CA USA) molecular platform to increase sensitivity and specificity of TB diagnosis; (iii) WHO endorsed evriMED™ (Wisepill, Somerset West, South Africa) digital adherence monitoring technology to remotely assess TB treatment adherence by monitoring daily opening of an electronic pill box. | Digital technologies and innovations | The incremental cost per additional TB patient diagnosed in DrOTS was 2,631$ | There was a 61.2% (95% CI 58.1–65.2, P < 0.05) increase in case finding and treatment initiation over usual care. With the implementation of digital adherence monitoring technologies, those outcomes were respectively 405 (91.0%) and 40 (9.0%) in DrOTS. This represents a 2.6% (95% CI −1.8 to 7.5, P = 0.47) increase in successful outcomes | DrOTS has an ICER value of $177 per DALY averted compared to usual care for diagnosis and treatment of TB | Innovative technology packages including drones, digital adherence monitoring technologies, and molecular diagnostics for TB case finding and retention within the cascade of care can be cost effective. Their integration with other interventions within health systems may further lower costs and support access to universal health coverage |
| Prinja et al. (2018) (25) | ReMiND (REducing Maternal and Newborn Deaths), a mHealth application that tracks and supports clients for the Accredited Social Health Activist (ASHA) workers and provides inputs for individualized service and counseling needs | Digital technologies and innovations | From societal perspective, there was a cost saving of USD 425 million with ReMiND intervention | The implementation of ReMiND from 2011 to 2020 would save 4,127,529 DALYs | From societal perspective, intervention resulted in a cost saving of USD 90 per DALY averted and USD 2,569 per death averted. From health system perspective, the intervention determined an incremental cost of INR 12,993 (USD 205) per DALY averted and INR 371,577 (USD 5,866) per death averted | Findings of our study suggest strongly that the mHealth intervention as part of the ReMiND intervention is very cost effective from Indian health system's viewpoint, and cost saving from a societal perspective, and should be considered for replication elsewhere in India |
| Lowry et al. (2020) (14) | Digital Breast Tomosynthesis (DBT), a 3d diagnostic imaging system | Digital technologies and innovations | The transition from conventional Digital Mammography (DM) to DBT increased total costs by $395,553–445,722 per 1,000 screening-eligible women | In the base case analysis, breast cancer mortality and life-years were overall consistent between the DBT and DM screening scenarios. Small QALY gains were seen with DBT compared to DM, with incremental gains ranging from 1.97 to 3.27 per 1,000 women | The ICERs for DBT relative to DM ranged from $195,026–270,135 per QALY gained | DBT reduces false-positive exams while achieving similar or slightly improved health benefits. At current reimbursement rates, the additional costs of DBT screening are likely high relative to the benefits gained; however, DBT could be cost-effective at lower screening costs |
| Krishnan et al. (2019) (8) | Shape intervention offered: (a) tailored behavior change goals; (b) skills training materials; (c) weekly interactive voice response telephone calls; (d) monthly telephone coaching from a registered dietitian; (e) a no-cost 12-month membership to a facility of their choice | Telephone support | The incremental cost of Shape relative to usual care was US $758 | The primary measure of effectiveness in the trial was weight change from baseline to 12 months. Weight change was converted into a health-related quality of life change score. Mean difference in weight change of the intervention and usual CARE arms with regard to baseline approached statistical significance at the 12-month (−1.4 kg [−2.8 to −0.1]) assessment. The difference in weight change across arms was transformed to QoL change scores for Shape participants and usual care participants (+0.009 and +0.005, respectively) | In the base case, the ICER was of US $55,264 per QALY gained | Shape intervention is cost-effective based on established benchmarks, indicating that it can be a part of a successful strategy to address the nation's growing obesity epidemic in low-income at-risk communities |
| Levy et al. (2017) (21) | Phone conversation with a tobacco treatment specialist (TTS) about smoking cessation counseling. In addition, the TTS offered to connect patients with social services via HelpSteps.com, a web-based clearing-house for local social services relevant to low-income individuals | Telephone support | The incremental cost per additional quit is $4,137 (95% CI $2,671– $8,460) over the 20-month study period | Comparing intervention to usual care, we estimate a risk difference of 9.7%, or approximately 69 (95% CI 33–108) incremental quits (9.7% × 707 smoker participants) based on the intention to treat analysis | The overall incremental cost per additional life year saved is $7,301 (95% CI $4,545–$15,400) | The proactive population-based smoking cessation program tested in Project CLIQ under conservative assumptions did not appear as cost-effective as a related strategy, but demonstrated favorable cost-effectiveness compared to other smoking cessation programs and is likely to be highly cost-effective by common cost-effectiveness thresholds ($50,000–$150,000/additional quality-adjusted life year) compared to other health interventions |
| Romero-Sanchiz et al. (2017) (35) | Internet-based Cognitive-Behavioral Therapy intervention program (“Smiling is Fun”) for depression with or without psychotherapist support | Web platforms and digital health portals | The totally self-guided (TSG) Internet-based program led to save USD 644.11 per patient in comparison with improved treatment as usual (iTAU) | The effectiveness was measured as reduction of Beck Depression Inventory II (BDI-II), and totally self-guided Internet-based program led to a reduction of 3.80 point in comparison with improved treatment as usual | The complete case analyses revealed an incremental cost-effectiveness ratio (ICER) of €−169.50 for the TSG group compared with iTAU | The results of this study indicate that Internet-based CBT interventions are appropriate from both economic and clinical perspectives for depressed patients in the Spanish primary care system. These interventions not only help patients to improve clinically but also generate societal savings |
| Watson et al. (2018) (32) | Internet-based cognitive-behavioral therapy for bulimia nervosa (CBT-BN) | Web platforms and digital health portals | The average cost per abstinent patient at 1-year follow-up was $16,777 (95% CI = $10,298, $27,042) for face-to-face and $14,561 (95% CI = $10,165, $21,028) for Internet-based CBT-BN | The primary outcome of abstinence for Internet-based CBT-BN was inferior to face-to-face CBT-BN at post-treatment but non-inferior at 1-year follow-up QALY gain: over the course of treatment, participants in each group gained on average ~1 week of full health. At the end of one year, those in face-to-face had gained 4 weeks of full health and those in Internet-based gained 5 weeks. The clinical significance of these differences are small |
Not mentioned | Cost-effectiveness of Internet-based CBT-BN is comparable with that of an accepted standard. Internet-based dissemination of CBT-BN may be a viable alternative for patients geographically distant from specialist eating disorder services who have an unmet need for treatment |
| Nordyke et al. (2019) (27) | Implementation and use of software to treat disease in Type 2 Diabetes and Hypertension patients | Web platforms and digital health portals | Average Health resource utilization (HRU) savings ranged from $97 to $145 per patient per month | Not reported | At a willingness-to-pay threshold of $50,000/QALY, the intervention is estimated to be cost effective at total 3-year program costs of $6,468 (T2DM) | The Digital therapeutics studied may provide substantial cost savings, in part by reducing the use of conventional medications. Clinical inertia may limit the full cost savings of digital therapeutics |
| Sharifi et al. (2017) (40) | Study of Technology to Accelerate Research (STAR) intervention is a electronic health records (EHRs) modified to facilitate childhood obesity management by prompting diagnosis and providing decision support and electronic resources for evaluation, management, and follow-up care | Web platforms and digital health portals | Over 10 years, the intervention would cost $239 million or $119 per child reached | Relative to usual care, the intervention could reduce mean per capita BMI by 0.5 U among those reached | It is estimated an intervention cost of $237 per BMI unit reduced. At 10 years the intervention would avert 42,900 cases of obesity and 226,000 lifeyears with obesity at a net cost of $4,085 per case and $774 per year with obesity averted | This childhood obesity intervention with electronic decision support for clinicians and self-guided behavior-change support for parents may be more cost-effective than previous clinical interventions |
| Oostingh et al. (2019) (12) | Smarter Pregnancy, a mHealth coaching program in addition to the usual care in women of subfertile couples who start their first in vitro fertilization (IVF) cycle | Text messaging intervention | From health care perspective, intervention led to save €206.300, in comparison to usual care From societal perspective, intervention led to save €270.000, in comparison to usual care | Measure of effectiveness was expressed as the number of ongoing pregnancies after two IVF cycles and the use of the mHealth program resulted in 86 additional pregnancies | The ICERs from health care and societal perspectives per additional ongoing pregnancy equaled –€2,250 (95%CI −3,030 to −760) and –€3,050 (95% CI −3,960 to −540), respectively | The mHealth coaching program Smarter Pregnancy is potentially cost saving for subfertile couples preceding their first IVF treatment with low costs and promising cost-effectiveness estimates |
| Jo et al. (2019) (23) | mCARE package, a mobile phone-based system to improve communication and coordination between community health providers and the pregnant women they serve | Text messaging intervention | Overall, the total incremental cost of the comprehensive mCARE group compared to the basic mCARE group is estimated as $319,000 over the two years of implementation | Once adjusting for a population of 1 million, it was estimated a difference of 354 (uncertainty range 145–571) newborn deaths averted between the intervention and comparison groups | The comprehensive mCARE group (with SMS and home visit reminders) was highly cost-effective compared to the basic mCARE group with $901 per death averted and $31 per DALY averted | Study findings suggest that the addition of SMS and home visit reminders based on a mobile phone-facilitated pregnancy surveillance system may be cost-effective. Incorporating mHealth strategies such as SMS and home visit reminders to proven community-based delivery strategies may improve service utilization and program cost effectiveness in lowresource settings |
| Cleghorn et al. (2019) (24) | Intervention was a national mass media promotion of selected smartphone apps for weight loss compared with no dedicated promotion | Text messaging intervention | Costs to the health system of New Zealand was $2.3 million over the lifetime of the modeled population | The estimated impact of the base-case intervention was a health gain of 29 QALYs | Costs per QALY gained (or the incremental cost-effectiveness ratio) were NZ $79,700 (US $53,600) for the standard download rate | The mass media promotion of a smartphone app for weight loss produced relatively small health gains on a population level and was of borderline cost-effectiveness for the total population |
| O'Sullivan et al. (2020) (26) | Intervention was a “healthy lifestyle package,” including dietary and exercise advice and a smartphone app to reinforce health messages to reduce the incidence of gestational diabetes mellitus | Text messaging intervention | There were no significant differences across intervention and control groups in mean cost of antenatal admissions, delivery costs or total health care utilization | Women in the intervention group lost fewer QALYs, though the difference was not statistically significant (2.75 vs. 2.85, P = 0.38) | The ICER for QALYs was €2,914 per QALY gained | Providing a mobile health-supported lifestyle intervention to pregnant women with an elevated BMI may be a cost-effective way of improving maternal and infant health |
| Islam et al. (2020) (11) | Text messaging intervention plus standard-care for patients with type 2 diabetes | Text messaging intervention | The calculation of the incremental costs showed that the text messaging intervention can be delivered at costs of 24 Int.$ per patient | A statistically significant difference in HbA1c was observed in favor of the intervention group | ICER of 38 Int.$ per 1% reduction in HbA1c and of 2,406 Intl.$ per QALY gained | The mobile phone text-messaging is an effective and cost-effective method in improving glycemic control Text-messaging might be a valuable addition to standard treatment for diabetes care in low-resource settings |
| Sjostrom et al. (2017) (38) | Mobile app Tät®, a treatment program focused on pelvic floor muscle training (PFMT), and information about stress urinary incontinence and lifestyle factors | Mobile phone-based systems and applications | The total cost per participant was higher in the app group (€547.0) than that in the control group (€482.4) | In the app group, there was significant improvement in QoL at follow-up. In contrast, the control group did not display a significant reduction in scores. In app group, 0.01006 QALY gain. In control group, 0.00158 QALY gain | The incremental cost effectiveness ratio was of €7,615.5 per QALY in the base case scenario | The app for treating stress urinary incontinence is a new, cost-effective, first-line treatment with potential for increasing access to care in a sustainable way for this patient group |
| Kumar et al. (2018) (22) | Mobile cognitive behavioral therapy (CBT) program for Generalized anxiety disorder (GAD) with e-learnings and techniques to help them manage their anxiety and receive individualized support from a coach over a 3-month program | Mobile phone-based systems and applications | From a payer perspective, mobile CBT reduces overall costs by approximately $339 million when compared to traditional CBT | Mobile CBT led to a gain of 34,108 QALYs when compared to traditional CBT and 81,492 QALYs when compared to the status quo | Incremental cost effectiveness of intervention when compared to traditional cognitive behavioral therapy was of 65,380 $/QALY Incremental cost effectiveness when compared to status quo was of 54,606 $/QALY | Mobile CBT may lead to improved health outcomes at lower costs than traditional CBT or no intervention and may be effective as either prevention or treatment |
| Modi et al. (2020) (39) | Innovative Mobile Technology for Community Health Operation (ImTeCHO), a job aid for staff of primary health centers to increase the coverage of maternal, neonatal, and child health MNCH care | Mobile phone-based systems and applications | The implementation of ImTeCHO resulted in an annual incremental cost of US $163,841 | Implementation of the ImTeCHO intervention resulted in 11 infant deaths per 1,000 live births averted in the per-protocol analysis. This implies a reduction of 16% infant deaths per-protocol in the study area. This resulted in an increase in 735 life years, with a life expectancy of 68.35 years | ImTeCHO is a cost-effective intervention from a program perspective at an incremental cost of US $74 per life-years saved or US $5,057 per death averted | The findings of the study strongly suggest that the mHealth intervention as part of the ImTeCHO program is cost-effective and should be considered for replication elsewhere in India |
| Song et al. (2018) (13) | Smartphone application named “Karada-no-kimochi“. The user can record their menstrual dates, basal body temperatures, and their mental and physical disorders. The application predicts the menstrual cycle, i.e. it predicts the next day of bleeding, the length of the menstruation period, and the ovulation day | Mobile phone-based systems and applications | The total cost of expenses, loss of productivity and application fee was less for the intervention group than for the control group by JPY 134,000 (USD 1,170) in total | The QALY in the intervention group was 6.84, which is 0.07 higher than that in the control group (6.77) | Incremental cost effectiveness of intervention when compared to traditional was of 1,914,285 JPY (USD 16,714) per QALY | This RCT study suggested that the use of “Karadano- kimochi” may be effective in reducing the onset of dysmenorrhea and depression. The cost-effectiveness analysis indicated a dominant result from the use of the application |
| Whetten et al. (2018) (17) | Telehealth platform that includes rapid radiograph image transfer and two-way audiovisual capacity, as well as report generating capacity. This enables consulting neurosurgeons and neurointensive care specialists to review imaging and talk with/examine the patient and generate a report | Video-conferencing system | The use of ACCESS led to save $4,241 ($3,952–$4,438) per patient | Intervention, in comparison with usual care, increased QALYs by 0.20 (0.14–0.22) | Incremental cost effectiveness when compared to traditional care was of $-21,205 per QALYs | The teleneurology program ACCESS is a cost-effective approach to managing patients with neuro-emergent conditions in rural areas. In addition to providing financial benefits, a teleneurology program produces better patient outcomes, and offers societal benefits through reduction of stroke related disability and increased convenience to patient's families |
| Yoo et al. (2016) (33) | Introduction of telemedicine in the Intensive Care Unit (ICU) | Video-conferencing system | Incremental cost of $516 per patient compared with ICU without telemedicine | The incremental effect in the intervention group was of 0.011 (0.005–0.017) QALYs | Incremental cost-effectiveness ratio was of $45,320 per QALY | Telemedicine in the ICU is cost-effective in most cases and cost saving in some cases |
| Thakar et al. (2018) (16) | Telemedicine consultation center | Video-conferencing system | The mean per episode cost was INR 2,338 (38.0 USD) for TeleMedicine (TM) care vs. INR 5,479 (89.o USD) for routine care. Intervention resulted to be cost saving | The effectiveness of telemedicine care was calculated using efficiency in terms of the percentage of successful TM consultations. The overall effectiveness of the TM-care group was 917.4 and that of routine care was 132.8 | The ICER value was calculated to be −34,900 INR (571.9 USD)/unit of effectiveness (2,338 −5,479 [38.3–89.8]/0.89–0.80) | TM care dominates the in-person care strategy by providing more effective and less expensive follow-up care for a remote post–neurosurgical care population in India |
| Buvik et al. (2019) (41) | Telemedicine consultations using real-time videoconferencing | Video-conferencing system | In comparison to routine care, the intervention produced an annual cost savings of €19,500 (USD 16,516) | The average QALYs gained per patient in the telemedicine group was .09 which was not significantly different to the .05 gain in the standard consultation group, P = 0.29 | Not mentioned | Video-assisted orthopedic consultations, rather than having patients travel to the specialist hospital for consultations, is cost-effective from both a societal and health sector perspective |
| Fusco and Francesco (2016) (31) | Standard Rehabilitation + Telerehabilitation after total knee replacement | Video-conferencing system | Intervention on average led to save $263 (95% CI –$382 to –$143) per person | The incremental effect was measured by the knee flexion range of motion (ROM) gained and by QALY gained | The ICER (adopting Ita-NHS perspective) is –€960 ($1,352)/QALY [ceiling ratio: €30,000 ($42,200)/QALY] | The analysis suggested the intervention to be cost-effective, even less expensive and more effective |
| Vestergaard et al. (2020) (19) | Telehealthcare solution (TeleCare North Heart Failure) in heart failure patients as add-on to usual care | Video-conferencing system | Telemedicine reduced total healthcare costs by 35% [5,668 ($7,557) off a base of 16,241 British Pounds Sterling ($21,654)] | The 1-year adjusted QALY difference between the telehealthcare solution and the usual care group was 0.0034 (95% CI: −0.0711 to 0.0780), indicating an insignificant gain in health-related quality of life (HRQoL) for patients receiving the tele-healthcare solutio | Based on the incremental cost and QALY estimates and an assumed cost-effectiveness threshold of £20,000 ($ 26,666) per QALY,27 the telehealthcare solution provides a positive incremental net monetary benefit (NMB) of £5,164 ($ 6,885)/QALYs | All scenario analyses showed the same result with telehealthcare associated with lower costs and an insignificant impact on patients' HRQoL |
| Painter et al. (2017) (28) | Telemedicine Outreach for Post-Traumatic Stress Disease intervention involving offsite PTSD care teams located at parent VAMCs to support on-site CBOC providers | Video-conferencing system | The overall incremental cost of the intervention was $2,495 (p < .01) per patient | The total QALY gain from intervention is 0.008 compared to usual care | The primary analysis resulted in a median ICER of $185,565 per QALY (interquartile range $57,675 to $395,743) | Because of the upfront training costs and the resource-intensive nature of the intervention, associated expenses were high. Although PTSD-specific effectiveness measures were significantly improved, these changes did not translate to QALYs in the main analysis |
| Wang et al. (2016) (36) | Telemedicine Center at the West China Hospital (TCWCH) program intervention (a digital network with video equipment and image transfer that can be used in simultaneously conducting longdistance education or consultation) | Video-conferencing system | Telemedicine network resulted in an estimated net saving of $2,364,525 (if the patients traveled to the hub) or $3,759,014 (if the specialists traveled to the spoke hospitals) | It is a cost-saving analysis, there is no clinical measurement | There is no ICER | The intervention was highly cost saving |
| Clarke et al. (2018) (7) | National Health Service Direct Telehealth program (that included the planning and administration of the program, developing operating policy and procedures and technical requirements, developing clinical process workflow for the call center, and reporting and management of data elements for evaluation) | Video-conferencing system | The average saving was £1,023 ($1,280) per patient per year | Measure of effectiveness was the resource utilization data obtained from multiple sources, including A&E visits, ambulance usage, and hospitalization | Data did not include quality of life, and so we were unable to undertake cost/benefit analysis | The wide variance on savings and the uncertainty of monitoring cost do not allow a definitive conclusion on the cost-effectiveness as an outcome of this study |
| Witt Udsen et al. (2017) (34) | Telehealthcare solution and monitoring by a community-based healthcare team, in addition to usual care for patients with chronic obstructive pulmonary disease | Video-conferencing system | The base-case adjusted mean difference in total costs between telehealthcare and usual care was €728 (967 USD) [95% CI −754 to 2,211 (1,001–2,936)] | The adjusted mean difference in quality-adjusted life-years gained was 0.0132 (95% CI −0.0083 to 0.0346) | The ICER is €55.327 (73,769 USD) per QALY | Telehealthcare is unlikely to be a cost- effective addition to usual care, if it is offered to all patients with chronic obstructive pulmonary disease and if the willingness-to-pay threshold values from the National Institute for Health and Care Excellence are applied |
| Lugo, et al. (2019) | An out-of-hospital Virtual Sleep Unit (VSU) based on telemedicine to manage all patients with suspected OSA | Video-conferencing system | Intervention on average led to save 153.34 € (181.04 USD) | The incremental effectiveness was estimated in 0.0108 QALYs | Not mentioned | The VSU offered a cost-effective means of improving QALYs than routine care. Our findings indicate that VSU could help with the management of many patients, irrespective of CPAP use |
| Nguyen et al. (2016) (18) | A Telemedicine Program, called Singapore Integrated Diabetic Retinopathy Program (SiDRP), that provides “real-time” assessment of diabetic retinopathy photographs by a centralized team of trained and accredited graders supported by a tele-ophthalmology information technology infrastructure | Video-conferencing system | Intervention (SiDRP) generates a cost savings of $173 per patient | The total QALY gain from the SiDRP is almost the same as the routine care model (i.e., 13.1129 vs. 13.1123 QALYs) | $-288.333 per QALYs | The SiDRP model saves costs compared with the traditional model. This provides evidence in support of extending the SiDRP model across Singapore and outside the public sector |
| de Jong et al. (2020) (29) | Telemedicine with myIBDcoach (my Inflammatory Bowel Disease coach) | Video-conferencing system | The intervention resulted in a mean annual cost saving of €547 (612 USD) per patient [95%CI €-1,029 to €2,143 (1,152–2,400 USD)] | Patients in the intervention group showed a mean gain in quality adjusted life years (QALY) of 0.002 (95%CI, [-0.022, 0.018]) | Not explicited | Telemedicine with myIBDcoach is cost saving and has a high probability of being cost effective for patients with IBD |
| Wan et al. (2019) (10) | A combination of telemedicine and shared medical appointments in transition-age young adults with Type 1 Diabetes | Video-conferencing system | There was no significant difference in total costs | No significant differences in 9-month quality-adjusted life; however, the control group had a larger decline from baseline in utility than the intervention group, indicating a quality of life (QoL) benefit of the intervention (difference in difference mean ± SD: 0.04 ± 0.09; P = 0.03) | No within-trial incremental cost-effectiveness ratio was calculated due to the lack of significant difference in 9-month total costs or QALYs | The intervention (CoYoT1) care model may help young adults with T1D maintain a higher QoL with no increase in costs |
| Oksman et al. (2017) (20) | A tele-based health-coaching intervention among patients with type 2 diabetes (T2D), coronary artery disease (CAD) and congestive heart failure (CHF) | Video-conferencing system | The incremental cost for intervention in comparison with control was of 432€ (488USD) [−135€ to 999€ (−153USD to 1,128USD)] | The cost-effectiveness plane for HRQoL (15D) after health coaching showed that the intervention was more effective compared to care as usual [0.009 (0.000–0.018)] | The overall incremental ICER was €48,000 (54,237 USD) per QALY | Based on the results of this study, health coaching improved the QoL of type 2 diabetes and coronary artery disease patients with moderate costs. However, the results are grounded on a short follow-up period, and more evidence is needed to evaluate the long-term outcomes of health-coaching programs |
| Lopez-Villegas et al. (2020) (37) | Telemonitoring (TM) of patients with pacemakers in comparison with conventional monitoring (CM) | Video-conferencing system | Incremental costs per patient included in the TM vs. CM group constituted €1,807.87 (USD 2,006.52) [CI: −646.99 to 4,262.73 (−718.08 to 4,731.11)] from the perspective of the NHS and €1,865.52 (USD 2,070.50) [CI: −608 to 4,335.25 (674.81–4,811.6)] including patient/family cost | This study provided evidence showing that 12 months after pacemaker implantation, health-related quality of life was similar between groups of RM and conventional follow-up in hospital | The mean ICER amounted to €53,345.27 (USD 59.206,38) from the perspective of the NHS or €55,046.40 (USD 61.094.78) including patient/caregiver costs | Cost–utility analysis of TM vs. CM shows inconclusive results because of broad confidence intervals with ICER from potential savings to high costs for an additional QALY, with the majority of ICERs being above the usual NHS thresholds for coverage decisions |
| Hoyo et al. (2019) (30) | Telemonitoring of Crohn's Disease and Ulcerative Colitis (TECCU) Web platform for telemonitoring complex inflammatory bowel disease and nurse-assisted telephone care | Video-conferencing system | TECCU determined a median cost reduction from a societal perspective of €211 (US $231) per patient (95% CI €−600 to 180 per patient; US $-657 to 197 per patient) | The incremental efficacy of TECCU was 0.19 (0.33–0.14) relative to control (median incremental efficacy calculated with the bootstrapping procedure was 0.21, 95% CI −0.07 to 0.66) | TECCU vs. control estimated a median ICER of €−1,005 (95% CI €−13,518 to 3,137; US $1,100, 95% CI US $-14,798 to 3,434) | There is a high probability that the TECCU Web platform is more cost-effective than standard and telephone care in the short term |