Presentation (CTI)

OBJECTIVES: After discharge from an index heart failure (HF) admission, remote monitoring of patients has potential to improve care. The HF Management System (HFMS) is an option for remote monitoring and data show fewer heart failure (HF)-related readmissions at 90 and 365 days. The budget-impact implications of HFMS use for payers in the US are explored here.
METHODS: A published Markov model comparing standard of care monitoring (SOC) to HFMS was updated to reflect new one-year data, which were included in the HFMS arm as relative risks (RR) applied to SOC rates. Where one-year between-arm differences were not significant a conservative RR of 1.0 was applied. SOC event rates were taken from a meta-analysis of proportions. Costs were identified through structured searches and inflated to 2025 USD; the HFMS device cost was included based on 2025 US reimbursement rates. Primary outcomes were total cost per patient and cost per member per month (PMPM). One-way and probabilistic (2,000 Monte Carlo simulations) sensitivity analyses were performed, with probabilistic results presented as 95% credible intervals (CrI). A US insurance-payer perspective and one-year time horizon were used.
RESULTS: In the base case, the total cost per patient was $49,918 in the SOC arm corresponding to $11.02 PMPM. At one year, the RR for hospital readmission for HFMS versus SOC was 0.70 (95% confidence interval: 0.52 to 0.95) in the BMAD trial. The total cost for HFMS, including device costs, was $40,001 or $8.83 PMPM. In probabilistic analysis, the median savings were $9,616 (95% CrI: $1,726-$18,903) for total costs and $2.12 PMPM (95% CrI: $0.38-$4.17). Principal drivers were hospital readmission rates, and the cost of a readmission stay.
CONCLUSIONS: The use of HFMS is expected to reduce hospital admissions and to be cost saving from the US payer perspective.