Table 1 Summary of the economic evaluations
From: Using QALYs in telehealth evaluations: a systematic review of methodology and transparency
Article | Intervention sample size (N) | Utility data | Utility intervals | Costing | Difference in costs and QALYs | Key findings (ICER and cost effectiveness results) |
|---|---|---|---|---|---|---|
Barnett 2007 [25] USA | Messaging and video for diabetes N = 370 | SF-6D (SF-36) | Baseline and 12 months | Health provider, no cost information provided | Difference in QALYs or costs not reported | $60,940 per QALY and cost effective, 23% cost effective at $20 0000, 37% at $100,000 and 42% at a threshold of $200,000 |
Blankers 2012 [28] Netherland | Internet therapy for harmful alcohol use N = 136 | EQ-5D | Baseline and 6 months | Health provider and societal, comprehensive | 0.06 QALYs gained, CI/p not reported, increased costs (NS) | Median cost per QALY €14,710. The intervention had a 60% likelihood of being cost effective at threshold €20,000 |
Franzen 2009 [26] Sweden | Telephone follow-up for injured road users N = 510 | EQ-5D | Baseline, (3)§, and 6 months | Intervention costs for the health system | 0.01 QALYs gained, increased costs, CI/p not reported | 42,500 SEK per QALY and cost effective |
Graves 2009 [31] Australia | Telephone intervention for physical activity N = 431 | SF-6D (SF-36) | Baseline, 4 and 12 months | Health provider, comprehensive | QALYs gained not explicitly reported on individual level*, increased costs | Telehealth vs usual care $78,489 per QALY and not cost effective. Telehealth vs real control (no follow up) $29 375 per QALY and cost-effective |
Graves 2009 [32] Australia | Telephone support to prevent re-hospitalisation N = 122 | EQ-5D mapped from SF-12 | Baseline 4, 12, and 24 weeks | Health provider, comprehensive | 0.118 QALYs gained (S), reduced costs NS | NMB $7,907. 100% probability of increased QALYs and 64% probability of reduced costs |
Handley 2008 [47] USA | Telephone follow-up in diabetes care N = 226 | SF-6D (SF-12) | Baseline and 12 months | Intervention costs for the health provider | 0.012 QALYs gained, increased costs, CI/p not reported | $65,167 per QALY gained and within accepted cost effective range without specification |
Herbert 2008 [33] USA | Telephone follow-up in heart failure N = 406 | HUI3 and EQ-5D mapped from SF-12 | Baseline, 3, 6, 9 and 12 months | Societal and payer, comprehensive | 0.0497 QALYs gained (HUI3) 0.0430 QALYs gained (EQ-5D) (S), no difference in costs | $17,543 (EQ-5D) and, $15,169 (HUI3) with a 64% and 77% probabilities of cost-effectiveness |
Kimman 2011 [42] Netherland | Telephone follow-up after breast cancer treatment N = 299 | EQ-5D | Baseline, 3, 6, and 12 months | Societal, comprehensive | QALY gained not reported, increased costs | Telephone the preferred strategy. At a threshold of €80,000, 62% probability of being cost effective |
Moss-Morris 2012 [27] UK | Internet and telephone follow-up for fatigue N = 40 | EQ-5D | Baseline and 10 weeks | Health provider | 0.015 QALYs gained (S), no difference in costs | The intervention is cost-effective |
Neelemaat 2012 [43] Netherland | Telephone support to malnourished elderly N = 210 | EQ-5D | Baseline and 3 months | Societal, comprehensive | 0.02 QALYs gained (NS), increased costs | €26,962 per QALY. For thresholds at €20 000 the probability of cost effectiveness is 50% |
Pyne 2010 [34] USA | Video-link and telephone support for depression N = 335 | SF-6D (SF-12) QWB | Baseline, 6 and 12 months | Health provider and patient, comprehensive | QWB 0.015 QALYs gained (NS), SF-6D 0.018 QALYs gained (S), increased costs | $85,634 per QALY (health provider), $132,175 per QALY (incl. patient costs) Not cost-effective |
Smith 2008 [35] USA | Monitoring in heart failure N = 1069 | SF-6D (SF-36) | Not reported | Health provider | Difference in QALYs not reported, increased costs | $146,870 per QALY, Not cost-effective |
van der Meer 2011 [45] Netherland | Internet intervention for asthma N = 200 | EQ-5D | Baseline, 3, and 12 months | Societal, comprehensive | 0.024 QALYs gained (NS), no difference in costs | $26,700 per QALY, 62% probability of cost-effective at threshold of $50,000 |
van Keulen 2010 [44] Netherland | Intervention to motivate patients with hypertension N = 1629 | SF-6D (SF-36) | Baseline and 7 months | Intervention cost and time costs for the participants | 0.02 QALYs gained (S) Telephone most costly | Control group most cost effective for ceiling ratios lower than $2851 per QALY |
Van Wier 2012 [46] Netherland | Telephone and e-mail advice for overweight N = 1386 | EQ-5D | Baseline, 6, 12, 18 and 24 months | Societal, comprehensive | Phone 0.001 and Internet 0.01 QALYs gained NS, no difference in costs | Internet €1337 per QALY and not cost-effective. Phone €245,000 per QALY. Cost effective at WTP €20,000; 8% for Phone, 60% for Internet and 32% for control |
Willems 2007 [29] Netherland | Home monitoring of asthmatics N = 109 | SF-6D (SF-36) EQ-5D | Baseline, 4, 8 and 12 months | Societal, comprehensive | Adults 0.03 and children 0.01 QALYs gained (EQ-5D) (S), increased costs (NS) | €31,000 per QALY gained for adults and €59, 000/QALY gained for the children. Limited cost-effectiveness |
Yardly 2012 [30] UK | Telephone support for dizziness N = 236 | EQ-5D | Baseline, 3 and 12 months | Health provider | 0.022 QALYs gained, Increased costs, CI/p not reported | £1363 per QALY, Intervention is cost effective |