Economic analysis of remote monitoring of cardiac implantable electronic devices. Results of the Health Economics Evaluation Registry for Remote Follow-up - TARIFF.

Remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) has been demonstrated to improve out-patient clinic workflow and patient management. However, few data are available on the socio-economic impact of RM.The aim of this study was to assess the costs and benefits of RM compared with standard care (SC).We used 12-month patient data from the TARIFF study (n=209 patients: RM=102, SC=107). Cost comparison was made from two perspectives: the Healthcare system (HCS) and Patients. The use of healthcare resources was defined on the basis of hospital clinical folders. Out-of-pocket expenses were reported directly by patients.HCS perspective: The overall mean annual cost/patient in the SC group (€ 1,044.89±1,990.47) was significantly higher than in the RM group (RM: € 482.87±2488.10, p<0.0001), 53.87% lower in RM. The primary driver of cost reduction was the cost of cardiovascular hospitalizations (SC: € 886.67±1,979.13 vs RM: € 432.34±2,488.10 €, p =0.0030). Patient and caregiver perspective: The annual cost incurred by patients was significantly higher in the SC group than in the RM group (SC: € 169.49±189.50 vs RM: € 56.87±80.22; p<0.0001). Patients' quality-adjusted life-years were not significantly different between the groups. Provider perspective: The total number of in-hospital device follow-up visits was reduced by 58.78% in the RM group.RM of CIED patients is cost-saving from the perspectives of the HCS, patients and caregivers. Introducing appropriate reimbursements will make RM sustainable even for the provider and encourage widespread adoption of RM.