COST-UTILITY ANALYSIS OF A DIGITAL HEALTH INTERVENTION FOR HEART FAILURE MANAGEMENT EVIDENCE FROM A RANDOMIZED CONTROLLED TRIAL
Author(s)
Tooba Malik, PhD.
Student, Universiti Sains Malaysia, Pinang, Malaysia.
Student, Universiti Sains Malaysia, Pinang, Malaysia.
OBJECTIVES: To evaluate the cost-utility of the CareAide mHealth intervention compared to standard care in heart failure patients.
METHODS: A cost-utility analysis (CUA) was conducted alongside a 6-month RCT at an outpatient cardiology clinic in Hospital Pulau Pinang. A total of 162 patients were recruited, with 141 completing the full longitudinal follow-up (Intervention: n=71; Control: n=70). The intervention group received standard heart failure (HF) care and access to the CareAide mobile application. The control group received only standard HF care. Health utilities were elicited via the AQoL-6D and EQ-5D instruments and converted to QALYs. The primary outcome was the Incremental Cost-Effectiveness Ratio (ICER). Stochastic uncertainty was addressed through Probabilistic Sensitivity Analysis (PSA) via a Cost-Effectiveness Acceptability Curve (CEAC).
RESULTS: The intervention group achieved a significantly higher mean utility score than the control group (0.82 vs. 0.74), resulting in a mean QALY gain of 0.08. Total direct medical costs were significantly lower in the intervention arm (RM 5,181.60 vs. RM 7,787.85), yielding an average cost saving of RM 2,606.25 per patient. The resulting ICER was -RM 32,578.13 per QALY gained, categorizing the intervention as an effective strategy. Sensitivity analyses and the CEAC indicated a 100% probability of cost-effectiveness at Malaysian willingness-to-pay thresholds.
CONCLUSIONS: Mobile health apps are a dominant strategy, offering superior health outcomes at a lower cost. These results provide a compelling economic justification for integrating mHealth platforms into national cardiovascular management frameworks to optimize patient quality of life.
METHODS: A cost-utility analysis (CUA) was conducted alongside a 6-month RCT at an outpatient cardiology clinic in Hospital Pulau Pinang. A total of 162 patients were recruited, with 141 completing the full longitudinal follow-up (Intervention: n=71; Control: n=70). The intervention group received standard heart failure (HF) care and access to the CareAide mobile application. The control group received only standard HF care. Health utilities were elicited via the AQoL-6D and EQ-5D instruments and converted to QALYs. The primary outcome was the Incremental Cost-Effectiveness Ratio (ICER). Stochastic uncertainty was addressed through Probabilistic Sensitivity Analysis (PSA) via a Cost-Effectiveness Acceptability Curve (CEAC).
RESULTS: The intervention group achieved a significantly higher mean utility score than the control group (0.82 vs. 0.74), resulting in a mean QALY gain of 0.08. Total direct medical costs were significantly lower in the intervention arm (RM 5,181.60 vs. RM 7,787.85), yielding an average cost saving of RM 2,606.25 per patient. The resulting ICER was -RM 32,578.13 per QALY gained, categorizing the intervention as an effective strategy. Sensitivity analyses and the CEAC indicated a 100% probability of cost-effectiveness at Malaysian willingness-to-pay thresholds.
CONCLUSIONS: Mobile health apps are a dominant strategy, offering superior health outcomes at a lower cost. These results provide a compelling economic justification for integrating mHealth platforms into national cardiovascular management frameworks to optimize patient quality of life.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE43
Topic
Economic Evaluation
Topic Subcategory
Trial-Based Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory)