New findings from the ECOST study underscore the economic benefits of BIOTRONIK Home Monitoring for the French National Health Insurance system
BIOTRONIK Home Monitoring significantly reduces the cost of follow-up in patients with implantable defibrillators (ICDs). New data from the ECOST (Effectiveness and Cost of ICD Follow-Up Schedule with Telecardiology) study show remote monitoring saves the French National Health Insurance system costs, in addition to being safe and efficient.1
Over a 27-month follow-up period, ambulatory costs were significantly reduced, while hospital costs were not significantly different. Adding ICD costs to ambulatory costs, the savings generated by BIOTRONIK Home Monitoring amounted to €315 per patient per year, including the cost of the remote monitoring service.
"These new results show that the remote monitoring of ICD patients saves costs in addition to improving patient care and optimizing the use of health care resources", commented Dr. Guedon-Moreau of the Centre Hospitalier Regional at the University of Lille, France. "The main results of the ECOST study,2 published in February 2013, proved an undeniably good safety benefit," said Prof. Kacet, also of the Centre Hospitalier Regional. "Using BIOTRONIK Home Monitoring reduced the number of patients with inappropriate shocks by 52% and the risk of hospitalization related to those shocks by 72%."
ECOST was a prospective multicenter clinical trial designed to examine the safety and efficacy of remote monitoring of ICD patients with BIOTRONIK Home Monitoring. The study analyzed 433 patients from 43 sites throughout France who were randomly assigned to remote monitoring follow-up or standard in-office care. The 221 remote monitoring patients - the active group - were seen in the ambulatory department once a year, unless remote monitoring reported a technical or clinical event requiring an in-office visit. The 212 control group patients underwent in-office visits every six months.
Costs were calculated using the French National Health Insurance fund's actual billings, and consider hospital costs for the management of cardiovascular disorders and ambulatory costs including costs related to device management and other ambulatory costs. By reducing shocks, BIOTRONIK Home Monitoring has a positive impact on battery life, meaning devices need to be replaced less frequently.3 The cost savings shown in the 27-month study are expected to increase over time.
Savings Can Be Used to Reimburse Physician Services
The economic analysis of the ECOST study did not take into account physician fees for remote monitoring, as they are not yet reimbursed by the French National Health Insurance system. French authorities are currently negotiating how to reimburse physicians for remote follow-ups. The expenses saved by BIOTRONIK Home Monitoring should be reallocated to adequately reimburse remote physician services. In this way, BIOTRONIK Home Monitoring offers improved patient care at no additional cost to the French health care system.
"In addition to the manifest economic benefits of BIOTRONIK Home Monitoring, numerous studies have been published over the past few years confirming its clinical and safety benefits. The results of the IN-TIME study, recently presented at the European Society of Cardiologists' 2013 conference, reinforce these excellent clinical outcomes by, for the first time, demonstrating a reduction in mortality due to BIOTRONIK Home Monitoring," commented Christoph Böhmer, President International of BIOTRONIK. "The European Society of Cardiology's recent recommendation for using implant based remote monitoring indicates that remote monitoring will play an even greater role in the future."
1 Guedon-Moreau et al. Europace Forthcoming 2014.
2 Guedon-Moreau et al. Eur. Heart J 2013. See also TRUST trial: Varma et al. Circulation 2010.
3 Guedon-Moreau et al. Eur. Heart J 2013.