BUDGET IMPACT OF A LONG-TERM AMBULATORY ECG MONITORING PATCH (ZIO XT) COMPARED WITH HOLTER MONITORING IN ENGLAND
Author(s)
Eoin Moloney, MSc1, Amir Ansaripour, MSc, PhD2, Mehdi Javanbakht, MSc, PhD1, Erik M. Hendrickson, MA, MPH, PhD3, Angelina Irizari Policarpio, MBA, RN3, Genevieve Bean, PhD3.
1Optimax Access, Southampton, United Kingdom, 2Optimax Access, Rotterdam, Netherlands, 3GVAP department, iRhythm Technologies, San Francisco, CA, USA.
1Optimax Access, Southampton, United Kingdom, 2Optimax Access, Rotterdam, Netherlands, 3GVAP department, iRhythm Technologies, San Francisco, CA, USA.
OBJECTIVES: Atrial fibrillation (AF) is a major risk factor for stroke, yet detection can be challenging using conventional ambulatory electrocardiogram (ECG) monitoring. This study evaluated the budget impact of adopting a long-term ECG monitoring patch (Zio XT) compared with Holter monitoring in England and assessed its impact on healthcare resource utilisation, costs, and secondary stroke prevention.
METHODS: A budget-impact model was developed from the perspective of the National Health Service (NHS) and Personal Social Services in England over a five-year time horizon. The model evaluated patients undergoing ambulatory ECG monitoring for palpitations, syncope with arrhythmia, AF, and stroke/transient ischaemic attack. Two scenarios were compared: standard care using Holter monitoring and a scenario incorporating the long-term monitoring patch. Costs included monitoring, outpatient appointments, repeat testing, implantable loop recorder (ILR) use, anticoagulation, healthcare, and social care costs. Outcomes included budget impact, resource utilisation, and stroke-related costs.
RESULTS: In a cohort of 1,000 eligible patients annually, adoption of the long-term monitoring patch generated cumulative savings of £616,740 over five years, corresponding to savings of £602 per patient. Savings were primarily driven by reductions in ILR utilisation (£508,031), follow-up appointments (£206,497), and repeat ambulatory monitoring (£41,289). Compared with Holter monitoring, the intervention avoided 287 repeat tests, 4,589 outpatient monitor fitting appointments, 1,147 follow-up appointments, and 82 ILR procedures over five years. In a secondary stroke prevention analysis, improved AF detection and subsequent anticoagulation treatment generated cumulative savings of £1.13 million over five years, including reductions in NHS costs (£863,077) and social care costs (£647,365), partially offset by increased device and anticoagulation costs.
CONCLUSIONS: Adoption of a long-term ambulatory ECG monitoring patch may reduce healthcare resource utilisation and generate substantial cost savings for the NHS in England compared with Holter monitoring. Additional downstream savings may be achieved through increased AF detection and subsequent stroke prevention.
METHODS: A budget-impact model was developed from the perspective of the National Health Service (NHS) and Personal Social Services in England over a five-year time horizon. The model evaluated patients undergoing ambulatory ECG monitoring for palpitations, syncope with arrhythmia, AF, and stroke/transient ischaemic attack. Two scenarios were compared: standard care using Holter monitoring and a scenario incorporating the long-term monitoring patch. Costs included monitoring, outpatient appointments, repeat testing, implantable loop recorder (ILR) use, anticoagulation, healthcare, and social care costs. Outcomes included budget impact, resource utilisation, and stroke-related costs.
RESULTS: In a cohort of 1,000 eligible patients annually, adoption of the long-term monitoring patch generated cumulative savings of £616,740 over five years, corresponding to savings of £602 per patient. Savings were primarily driven by reductions in ILR utilisation (£508,031), follow-up appointments (£206,497), and repeat ambulatory monitoring (£41,289). Compared with Holter monitoring, the intervention avoided 287 repeat tests, 4,589 outpatient monitor fitting appointments, 1,147 follow-up appointments, and 82 ILR procedures over five years. In a secondary stroke prevention analysis, improved AF detection and subsequent anticoagulation treatment generated cumulative savings of £1.13 million over five years, including reductions in NHS costs (£863,077) and social care costs (£647,365), partially offset by increased device and anticoagulation costs.
CONCLUSIONS: Adoption of a long-term ambulatory ECG monitoring patch may reduce healthcare resource utilisation and generate substantial cost savings for the NHS in England compared with Holter monitoring. Additional downstream savings may be achieved through increased AF detection and subsequent stroke prevention.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE2
Topic
Clinical Outcomes, Economic Evaluation, Medical Technologies
Topic Subcategory
Budget Impact Analysis
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), No Additional Disease & Conditions/Specialized Treatment Areas