open access

Vol 79, No 5 (2021)
Original article
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Cost-effectiveness of telerehabilitation in patients with heart failure in Poland: an analysis based on the results of Telerehabilitation in the Heart Failure Patients (TELEREH-HF) randomized clinical trial

Maciej Niewada, Bernadetta Tabor, Ewa Piotrowicz, Ryszard Piotrowicz, Grzegorz Opolski, Maciej Banach, Michał Jakubczyk
DOI: 10.33963/KP.15885
·
Pubmed: 34125923
·
Kardiol Pol 2021;79(5):510-516.

open access

Vol 79, No 5 (2021)
Original article

Abstract

Background: Telerehabilitation in the Heart Failure Patients (TELEREH-HF) study showed a statistically significant improvement in the tertiary outcomes i.e. the New York Heart Association (NYHA) class after a 9-week follow-up, consistent with telerehabilitation-related benefits to quality of life (QoL) measured with the 36-item Short Form questionnaire (SF-36).

Aims: The study analyzed the cost-effectiveness of hybrid telerehabilitation compared to standard care in heart failure patients in the Polish setting using findings from the TELEREH-HF trial.

Methods: Cost-utility analysis was conducted from the perspective of a public payer (the Polish National Health Fund). The quality-adjusted life-year (QALY) measure was based on QoL, as survival benefit was not confirmed in the TELEREH-HF. Utility values were estimated based on NYHA improvement and a systematic review of NYHA-specific utility values. Alternatively, SF-36 results were translated into utility values. Telerehabilitation costs covered 8 weeks, 5 days/week, at a daily cost of 74 Polish zloty (PLN). Standard care costs resulted from extra in-patient and out-patient rehabilitation costs incurred for selected patients. A lifetime horizon was adopted, with an estimated average survival time of 3.9 years based on 2 years TELEREH-HF follow-up and subsequent literature-derived prognosis.

Results: Base case analysis yielded a 0.044 and 0.027 gain in QALY for the NYHA and SF-36-based approaches, corresponding to a cost per QALY of 58.7 and 96 thousand PLN, respectively. Sensitivity analysis confirmed that the cost per QALY value was likely below the official cost-effectiveness threshold in Poland.

Conclusions: The use of telerehabilitation was found cost-effective in Poland, i.e., the clinical benefits justify the additional costs.

Abstract

Background: Telerehabilitation in the Heart Failure Patients (TELEREH-HF) study showed a statistically significant improvement in the tertiary outcomes i.e. the New York Heart Association (NYHA) class after a 9-week follow-up, consistent with telerehabilitation-related benefits to quality of life (QoL) measured with the 36-item Short Form questionnaire (SF-36).

Aims: The study analyzed the cost-effectiveness of hybrid telerehabilitation compared to standard care in heart failure patients in the Polish setting using findings from the TELEREH-HF trial.

Methods: Cost-utility analysis was conducted from the perspective of a public payer (the Polish National Health Fund). The quality-adjusted life-year (QALY) measure was based on QoL, as survival benefit was not confirmed in the TELEREH-HF. Utility values were estimated based on NYHA improvement and a systematic review of NYHA-specific utility values. Alternatively, SF-36 results were translated into utility values. Telerehabilitation costs covered 8 weeks, 5 days/week, at a daily cost of 74 Polish zloty (PLN). Standard care costs resulted from extra in-patient and out-patient rehabilitation costs incurred for selected patients. A lifetime horizon was adopted, with an estimated average survival time of 3.9 years based on 2 years TELEREH-HF follow-up and subsequent literature-derived prognosis.

Results: Base case analysis yielded a 0.044 and 0.027 gain in QALY for the NYHA and SF-36-based approaches, corresponding to a cost per QALY of 58.7 and 96 thousand PLN, respectively. Sensitivity analysis confirmed that the cost per QALY value was likely below the official cost-effectiveness threshold in Poland.

Conclusions: The use of telerehabilitation was found cost-effective in Poland, i.e., the clinical benefits justify the additional costs.

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Keywords

cost-effectiveness, heart failure, telerehabilitation

About this article
Title

Cost-effectiveness of telerehabilitation in patients with heart failure in Poland: an analysis based on the results of Telerehabilitation in the Heart Failure Patients (TELEREH-HF) randomized clinical trial

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 79, No 5 (2021)

Article type

Original article

Pages

510-516

DOI

10.33963/KP.15885

Pubmed

34125923

Bibliographic record

Kardiol Pol 2021;79(5):510-516.

Keywords

cost-effectiveness
heart failure
telerehabilitation

Authors

Maciej Niewada
Bernadetta Tabor
Ewa Piotrowicz
Ryszard Piotrowicz
Grzegorz Opolski
Maciej Banach
Michał Jakubczyk

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