Cost-effectiveness of Telemedicine-directed Specialized vs Standard Care for Patients With Inflammatory Bowel Diseases in a Randomized Trial

We read with attention the recently published article by de Jong et al1De MJ, al. Clin Gastroenterol Hepatol 2020 Apr 23;S1542-3565(20)30535-30538.Google Scholar about cost-effectiveness analysis of telemedicine-directed specialized versus standard care for patients inflammatory bowel diseases (IBD). The authors in 2017 largest multicenter clinical trial evaluating telemedicine IBD, enrolling a broad spectrum representative daily practice. In this new article, they found that was cost-effective compared care, using economic data collected alongside their pragmatic trial. However, and conversely to authors’ statements, is not first evaluation IBD. Furthermore, many analyses have been previously done different interventions used other diseases, systematic reviews were years ago summarize evidence regard.2Iribarren S.J. al.PloS One. 2017; 12e0170581Crossref PubMed Scopus (168) Google Scholar,3de la Torre-Díez I. al.Telemed J E Health. 2015; 21: 81-85Crossref (196) IBD setting, our research group several months cost-utility program (called TECCU), telephone care.4Del Hoyo J. al.J Med Internet Res. 2019; 21e15505Crossref (8) It important note did mention publication, considering methodology conclusions very similar those reproduced after them telemonitoring program. trial, differences between groups statistical uncertainty disease activity, quality-adjusted life-years, costs calculated nonparametric bootstrap estimations. Even if included 63 patients, we imputed original dataset 5 times bootstrapping estimations allowed us extract 1000 random samples (of 21 per arm) from each imputations, thus generating 5000 replications. concluded there high probability (79.96%) use TECCU web platform complex produces greater improvement activity at lower societal cost, care. There no on quality-of-life scores all 3 groups. Our promising results then provided information regarding help reorganize structure national health systems, further studies still necessary evaluate larger sample sizes over longer periods. Similarly, conclude myIBDcoach cost-saving has being cost-effective, without decline quality life. According conclusions, big size recruited useful confirm prior results, reproducibility favorable profile applied across countries patients’ characteristics. subtypes whereas study who needed start immunosuppressants and/or biologic agents. relation direct reported, components cost unit drugs detailed table costs. Moreover, estimate indirect only productivity loss because sick leave paid job included. Then, also lacks some as travel costs, leisure time so forth. Assuming limitations study, both are full analyses, evaluations performed articles. As indicate, implementation currently hindered result lacking cost-effectiveness. lack 1 main barriers implementation,5World Health OrganizationmHealth: horizons through mobile technologies. Geneva, Switzerland.https://www.who.int/goe/publications/goe_mhealth_web.pdfDate accessed: May 22, 2020Google but interfere wide practice, such interoperability problems, absence developed legal framework, reimbursement issues settings, Telemedicine communication, collaborative attitude based teamwork centers essential systems. Researchers must be able integrate limited available date, decision-makers do delay telemedicine, benefit its potential advantages near future. Finally, should accurate enough, prestige platforms supporting knowledge practice upset. Cost-effectiveness Telemedicine-directed Specialized vs Standard Care Patients With Inflammatory Bowel Diseases Randomized TrialClinical Gastroenterology HepatologyVol. 18Issue 8PreviewTelemedicine can monitor determinants outcomes chronic possibly increasing value reduce outpatient visits hospital admissions comparing Full-Text PDF