A new research paper by the London School of Economics (LSE) has found “the probability of cost effectiveness was low” in a high-profile UK trial of telehealth.
Previous research into different aspects of the same trial, known as the whole system demonstrator (WSD), has also expressed doubts about the remote monitoring of patients in their own homes.
The paper found the cost per quality adjusted life year (QALY), a standard measure in this kind of analysis, was £92,000 ($140,000) more than the cost of standard care.
This figure is in excess of the cost effectiveness threshold of £30,000 which is set by the UK National Institute for Health and Clinical Excellence (NICE). The probability of telehealth being cost effective was only 11 per cent, said the LSE.
NICE typically rejects drugs or treatments with a QALY of more than £20,000-£30,000.
The study covered 965 patients with long-term conditions, of which 534 received telehealth equipment and support while 431 received the usual care. It was published in the British Medical Journal.
Even if equipment costs fall by 80 per cent then telehealth would still be slightly more expensive than conventional care, said the study.
The results are not such a surprise, given one of the LSE’s researchers outlined early findings last summer. The £92,000 figure was first mentioned at the time.
Martin Knapp (pictured), professor of social policy at the LSE, told Reuters that the research did not mean telehealth was a waste of time but it did need to be targeted better. Better technology and greater scale might help, he added.
“We have got to find ways of better adjusting the equipment to suit the circumstances of the individual patient,” said Knapp.
Previous research has looked into other aspects of the same WSD trial. The most recent paper, which was published earlier in March, was led by City University and focused on whether telehealth can deliver psychological benefits to patients with chronic conditions.
The effect on remote monitoring on patients’ health-related quality of life was “weak or non-existent”, said the City University-led study.
Another study by the Nuffield Trust last year did find benefits from telehealth but only “modest” cost savings.
The UK’s WSD trial, and its subsequent analysis, has attracted interest around the world because of its scale. It involved thousands of participants when typically such trials involve smaller numbers.