Cost Effectiveness Analysis of Out-Patient and Remote Monitoring of Patients after Pacemaker Replacement from the Perspective of the Health Care Payer

Objectives: To determine the cost effectiveness of remote vs. outpatient monitoring of patients with pacemaker after device replacement due to battery depletion. Background: Despite the fact that modern pacemakers can be checked remotely, most checkups are still carried out during outpatient visits. So far, a cost effectiveness analysis of remote monitoring has not been performed in the Czech Republic. Patients, methods: A retrospective analysis was done using the files of 217 patients that had undergone pacemaker replacement between 2002 and 2005. All visits from 2002 to 2015 were analyzed. Using a pharmacoeconomic model, a cost minimization analysis was made to compare the costs of outpatient visits relative to remote monitoring of pacemakers, from the perspective of the health care payer. Results: The costs for the out-patient follow-up of the analyzed group of patients were calculated to be 802,709 CZK. Remote management for the same group would have cost 6,398,631 CZK. Cost minimization analysis showed that remote monitoring would have cost 5,595,922 CZK more than current standard care. Conclusion: Remote monitoring, is from the perspective of the health care payer, not associated with costs reduction in patients after pacemaker replacement due to battery depletion compared to standard out-patient follow-up. (c) 2018 The Czech Society of Cardiology. Published by Elsevier Sp. z o.o. All rights reserved.