CAN INDIVIDUAL HEALTH TECHNOLOGIES IMPROVE OVERALL CHRONIC DISEASE MANAGEMENT?

Author(s)

Brener SS*1;Nikitovic M1;Krahn MD2;Goeree R3, Levin L1 1Health Quality Ontario, Toronto, ON, Canada, 2Toronto Health Economics and Technology Assessment (THETA) Collaborative, Toronto, ON, Canada, 3PATH Research Institute, McMaster University, Hamilton, ON, Canada

OBJECTIVES: Chronic disease is resource intensive for health care systems. Considerable efforts have focused on the management of chronic disease in the community setting however the role of individual health technologies is often overlooked. The purpose of this analysis was to identify examples of individual health technologies that contribute to overall chronic disease management. METHODS: The Medical Advisory Secretariat (MAS) in Ontario has published a substantive body of evidence-based analyses on health technologies. The MAS Ontario Health Technology Assessment Series was searched for reports published between 2006 and 2011. Findings were limited to analyses that reported on health technologies with moderate to high quality evidence of effectiveness for chronic disease management. Outcomes of interest included health resource utilization, patient and clinical outcomes, and economic analyses measures. RESULTS: Two technologies had direct evidence of the cure of chronic disease. Bariatric surgery was effective in the resolution of diabetes among morbidly obese adults (77% resolution; 95% CI 71%-83%), with a cost of $15,697 Canadian dollars (CAD) per quality-adjusted life year (QALY) relative to usual care. Ablation for atrial fibrillation resulted in greater freedom from arrhythmia than medical treatment alone (RR 0.30; 95% CI 0.11-0.79), and downstream cost savings. Two technologies were effective in the prevention of chronic wounds and 8 technologies were effective in the management of chronic obstructive pulmonary disease, stroke, coronary artery disease, congestive heart failure or benign prostatic hyperplasia. Among these 10 technologies, all 5 analyses that reported incremental cost-effectiveness ratios were cost-effective based on a $50,000 (CAD) per QALY threshold. CONCLUSIONS: This review demonstrates that individual health technologies can be both effective and cost-effective in the overall management of chronic disease. Therefore health technologies can be a viable contributing factor to chronic disease management and should be considered as an integral component of community health care.

Conference/Value in Health Info

2013-05, ISPOR 2013, New Orleans, LA, USA

Value in Health, Vol. 16, No. 3 (May 2013)

Code

PHP118

Topic

Health Technology Assessment

Topic Subcategory

Decision & Deliberative Processes

Disease

Multiple Diseases

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