OBJECTIVES: Chronic heart failure (CHF) is associated with a substantial clinical and economic burden that impacts significantly on health care systems. The objective of this study is to assess the cost-utility of a new home telemonitoring (HTM) project in elderly CHF outpatients.METHODS: This prospective, 6-month, randomised trial was designed to compare the cost-effectiveness of a HTM project versus usual care (UC) in elderly patients with CHF, receiving optimal treatment and counselling. A total of 24 patients (aged 66-92 years) were assigned randomly to HTM or UC. At baseline and at the end of the study, all patients had a complete cardiologist’s assessment, including quality of life. The evaluation of the cost of HTM includes the cost of drug therapy, monitoring, treating side-effects, hospitalizations and devices. All costs were calculated from a third-party payer perspective, in 2007 Euros. RESULTS: The mean duration of the follow-up was similar for the two groups (136.92±36.65 days, P>0.05). There was a non-statistically significant reduction in hospital readmissions, hospitalisation days, physicians’ visits, laboratory tests and total costs (P>0.05) for HTM group. However, HTM was associated with a significant improvement in the QoL measured with the generic health-related EQ-5D questionnaire (10.00±7.24, P<0.001) and a small incremental gain of 0.13±0.24 quality-adjusted-life-years (QALYs) over UC. The analysis showed that the average incremental cost of HTM was €12,909±€53,313/QALY gained.CONCLUSIONS: HTM is likely to be a cost-effective intervention compared with UC in elderly CHF outpatients in Greece. However, further studies with more patients and longer duration are needed to confirm these results.