An economic evaluation of teledermatology care delivery for chronic skin diseases

Aim: Analyze the impact of nationwide implementation of teledermatological care for psoriasis. Methods: Develop a Markov model that estimates the impact of telehealth technology for treatment of moderate-to-severe psoriasis on health and healthcare expenditures compared with in-person clinical care. Results: Lower medical costs by US$1.5 billion and total social costs of US$4.3 billion over 5 years. Patients save more than 67 million hours in work absenteeism and travel time, valued at US$598 million. Employers save US$1.2 billion over 5 years due to decreased employee absenteeism. Conclusion: National implementation of telehealth for psoriasis care has the potential to substantially reduce both formal healthcare costs and informal costs for families and patients, while maintaining equivalent clinical outcomes as traditional in-person care. Lay abstract Recent innovations in telehealth (methods of accessing and managing healthcare using digital information and technologies, such as the computer or telephone) have allowed for convenient access to care for dermatology patients. A recent study found that psoriasis patients experienced similar quality of care outcomes when using telehealth services as they did when seeing a clinician in-person. This paper builds on previous work examining teledermatological care outcomes and aims to analyze the potential economic impacts of a nationwide implementation of telehealth for managing psoriasis. We model the impacts of healthcare utilization and costs, caregiver time loss, and work absenteeism costs between the telehealth and in-person care settings. These results produce cost savings to society of over US$4.3 billion over 5 years.