OBJECTIVES To estimate from the payer perspective, the cost and clinical consequences of a Remote Patient Monitoring (RPM) program, supported in Sharesource® technology, to improve the clinical practice in automated peritoneal dialysis (APD) in Baxter Renal Care Services (RCS) in Colombia.

METHODS A one year Markov analytic model, structured in five health states, was used to project costs and clinical outcomes from a hypothetical cohort of 100 APD incident patients with and without RPM. Hospitalization rates and length of stay were obtained from literature. Other clinical inputs such as peritonitis and technique failure rates were estimated from patient medical records in RCS. Monitoring and complication costs were estimated from reference national tariffs. Inpatient care costs were obtained from literature. Model results were reported as the RPM incremental effect in: overall direct costs, months free of complications, hospitalization episodes, days of hospitalization, complication episodes (peritonitis or APD technique failure) and one year APD technique persistence. Both deterministic and probabilistic sensitivity analyses were done to analyze the effect of parameter uncertainty in the model results.

RESULTS In comparison to APD without RPM, the implementation of a RPM program for 100 APD patients per one year resulted in: Overall savings of USD $ 111,115; 58 months free of complications; 26 hospitalization episodes avoided; 501 hospitalization days avoided; 7 complications episodes avoided and 9 additional patients persisted in APD technique after one year. In the deterministic sensitivity analysis, RPM tariff, hospitalization rate and hospitalization episode costs were the most sensitive drivers of the model results. In the probabilistic sensitivity analysis, there was a 93% of chance of dominance for the APD with RPM alternative.

CONCLUSIONS RPM supported by Sharesource® technology is a cost saving dominant alternative, improving patient time free of complication, hospitalization costs, complication costs and one year persistence in APD.