Alert-driven vs scheduled remote monitoring of implantable cardiac defibrillators: A cost–consequence analysis from the TRUST trial

doi:10.1016/j.hrthm.2022.12.003

Alert-driven vs scheduled remote monitoring of implantable cardiac defibrillators: A cost–consequence analysis from the TRUST trial

Heart RhythmPublished 8 Dec 2022Cost–consequence analysis (decision-analytic Markov model) of the TRUST randomised trial

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Authors' conclusion

Alert-driven RPM was economically attractive and, if patient outcomes and safety are comparable to those of conventional RPM, may be the preferred strategy for ICD follow-up.

Study context

Population: Patients with an implanted implantable cardioverter-defibrillator (ICD) (TRUST trial data)TRUST randomised 2:1
Participants: 1,339 patients

Comparison: In-person evaluation (IPE) vs remote patient monitoring (RPM)-conventional vs RPM-alert
Primary endpoint: Incremental cost
Follow-up: 2-year time horizon

Methodological details2-year time horizon, US Medicare payer perspective, Cost data from published literature

2-year time horizon
US Medicare payer perspective
Cost data from published literature

Primary result

As reported in the abstract

Mean cumulative follow-up costs per patient

IPE12,688mean · $

RPM-conventional12,001mean · $

RPM-alert11,011mean · $

Incremental cost

−687 $

95% CI -$2138 to +$638

RPM-conventional

Incremental cost

−1,677 $

95% CI -$3134 to -$304

RPM-alert

RPM-alert most cost-effective; cost-savings in simulations: 99%

Original publication

Alert-driven vs scheduled remote monitoring of implantable cardiac defibrillators: A cost–consequence analysis from the TRUST trial. Heart Rhythm. Published 8 December 2022. doi:10.1016/j.hrthm.2022.12.003

Read the original article ↗

Summarised from the published abstract; every number is checked against it