Cost-effectiveness modelling of telehealth for patients with raised cardiovascular disease risk: evidence from a cohort simulation conducted alongside the Healthlines randomised controlled trial.
OBJECTIVE
To investigate the long-term cost-effectiveness (measured as the ratio of incremental NHS cost to incremental quality-adjusted life years) of a telehealth intervention for patients with raised cardiovascular disease (CVD) risk.


METHODS
A cohort simulation model developed as part of the economic evaluation conducted alongside the Healthlines randomised controlled trial.


METHODS
Patients recruited through primary care, and intervention delivered via telehealth service.


METHODS
Participants with a 10-year CVD risk ≥20%, as measured by the QRISK2 algorithm, and with at least 1 modifiable risk factor, individually randomised from 42 general practices in England.


METHODS
A telehealth service delivered over a 12-month period. The intervention involved a series of responsive, theory-led encounters between patients and trained health information advisors who provided access to information resources and supported medication adherence and coordination of care.


METHODS
Cost-effectiveness measured by net monetary benefit over the simulated lifetime of trial participants from a UK National Health Service perspective.


RESULTS
The probability that the intervention was cost-effective depended on the duration of the effect of the intervention. The intervention was cost-effective with high probability if effects persisted over the lifetime of intervention recipients. The probability of cost-effectiveness was lower for shorter durations of effect.


CONCLUSIONS
The intervention was likely to be cost-effective under a lifetime perspective.


BACKGROUND
ISRCTN27508731; Results.
Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK.
Padraig
P
Dixon
Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK.
Sandra
http://orcid.org/0000-0003-0782-3117
S
Hollinghurst
ScHARR, The University of Sheffield, Sheffield, UK.
Roberta
R
Ara
Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK.
Louisa
L
Edwards
ScHARR, The University of Sheffield, Sheffield, UK.
Alexis
A
Foster
Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK.
Chris
http://orcid.org/0000-0002-4378-3960
C
Salisbury
Angina; HEALTH ECONOMICS; STROKE MEDICINE
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