UK Study Calls the Cost-Effectiveness of Telehealth into Question
A recent study by researchers in the United Kingdom concluded that telehealth isn’t a cost-effective way to deliver care. The study looked at hundreds of patients over the course of a year and determined that those using telehealth services experienced only slightly better quality of life compared with those who didn’t use telehealth. The results follow another study published in BMJ last month that compared levels of health-related quality of life and anxiety for patients both using and not using telehealth. That research concluded that telehealth did not improve quality of life or psychological outcomes for those patients.
How the study was conducted
The study published this month in BMJ looked at QALYs gained in heart failure, chronic obstructive pulmonary disease (COPD) and diabetes patients. QALY stands for quality-adjusted life years and is a measure of the quality of life per year lived. For each year a patient lives in perfect health, he accumulates one QALY. Patients whose health causes them to experience a lesser quality of life accumulate less than one QALY, such as .70 QALYs for example, per year.
In this case telehealth was defined as “the remote exchange of data between a patient and healthcare professional to assist in the diagnosis and management of a healthcare condition.” Between May 2008 and December 2009, 534 patients used telehealth equipment and support in addition to usual care, and 431 received just usual care.
The difference in QALY gain between the two groups was 0.012, with the telehealth group of patients receiving a slightly better outcome. “The probability of cost effectiveness judged by reference to this QALY measure was relatively low over a range of values of willingness to pay,” the authors wrote. They referred to a UK threshold of willingness to pay, which is usually £30,000 per QALY. This means that when the health system considers using a new drug or technology, it looks to spend less than that per QALY. In this study the cost per QALY of telehealth in addition to usual care was £92,000.
A limitation of this research was that it looked at only QALYs and didn’t consider patient outcomes. It’s also important to note that just three diseases were incorporated in this study, and telehealth is used to treat a wide range of diseases and conditions.