The TECCU-Based Telemonitoring Platform for Inflammatory Bowel Disease Is Cost-Effective: A Multicenter GETECCU Trial.
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Aguas Mariam, Del Hoyo Javier, Vicente Raquel, Barreiro-de Acosta Manuel, Melcarne Luigi, Hernandez-Camba Alejandro, Madero Lucía, Arroyo María Teresa, Sicilia Beatriz, Chaparro María, Martín-Arranz María Dolores, Pajares Ramón, Mesonero Francisco, Mañosa Miriam, Martinez Pilar, Chacón Silvia, Tosca Joan, Marín Sandra, Sanroman Luciano, Calvo Marta, Monfort David, Saiz Empar, Zabana Yamile, Guerra Iván, Varela Pilar, García-García Sonia, Faubel Raquel, Corsino Pilar, Porto-Silva Sol, Brunet-Mas Eduard, González Melodi, Gutierrez Ana, Nos Pilar, GETECCU
Аннотация
METHODS: A multicenter, randomized, noninferiority trial was performed in 24 Spanish centers, including adults with inflammatory bowel disease initiating immunosuppressants or biologics. Patients were assigned to telemonitoring using the Telemonitorización de la Enfermedad de Crohn y Colitis Ulcerosa (Telemonitoring of Crohn's Disease and Ulcerative Colitis) app or standard care. The primary outcome for cost-effectiveness analysis was time in remission. Quality-adjusted life-years were measured for the cost-utility. Health care- and patient-incurred costs, including travel expenses, distance, and time off work, were compared over 52 weeks.
RESULTS: Of 159 randomized patients (75 Telemonitorización de la Enfermedad de Crohn y Colitis Ulcerosa, 84 control), 126 completed 52 weeks. At 12 and 52 weeks, Telemonitorización de la Enfermedad de Crohn y Colitis Ulcerosa saved €698.47 (95% confidence interval, -24,561 to 23,164) and €8.29 (95% confidence interval, -20.9 to 37.5) per additional week in remission. Overall, Telemonitorización de la Enfermedad de Crohn y Colitis Ulcerosa was less costly than standard care in 73.5% of simulations. Considering quality-adjusted life-years, Telemonitorización de la Enfermedad de Crohn y Colitis Ulcerosa saved €998 (95% confidence interval, -4257 to 2261) and €1441 (95% confidence interval, -6362 to 3408) per additional quality-adjusted life-year, with a 90.3% probability of cost-effectiveness at a willingness-to-pay threshold of €20,000. The mean number of contacts per patient was similar (6.9 vs 7.0; P = .74), but Telemonitorización de la Enfermedad de Crohn y Colitis Ulcerosa reduced in-person visits (3.1 vs 4.8; P < .001). Health care costs were lower with Telemonitorización de la Enfermedad de Crohn y Colitis Ulcerosa (€326 vs €361; P < .001), and patients saved 52.27 ± 79.3 km traveled, 12.56 ± 8.2 hours off work, and €12.63 ± €15.9 in travel expenses.
CONCLUSIONS: Telemonitoring with the Telemonitorización de la Enfermedad de Crohn y Colitis Ulcerosa app reduces health care and societal costs while maintaining disease control, demonstrating its cost-effectiveness as a complementary strategy to standard care on a nationwide scale.
CLINICALTRIALS: gov, Number: NCT06031038.