Economic evaluation of the TriageHF Plus clinical pathway for device-based remote monitoring in heart failure

BACKGROUND: In 2024, the UK National Institute of Health and Care Excellence (NICE) recommended TriageHF alerts as an option for remote monitoring of patients with heart failure (HF) and a compatible cardiac implantable electronic device (CIED). Data on the cost-effectiveness of this approach has not been published. This research evaluates the cost-effectiveness of TriageHF Plus in public hospital settings, using data from the TriageHF Plus multicentre study (758 participants, NCT04177199). METHODS: An economic model was developed to capture the lifetime cost and benefits of TriageHF Plus versus usual care, based on a site of 300 eligible patients. Analysis on individual patient-level data informed model efficacy and resource use parameters. EuroQol five-dimensional questionnaire data and unit costs were obtained from published, peer-reviewed literature and national databases respectively. Costs and benefits were discounted at 3.5% per annum to adjust future costs and benefits to present value. RESULTS: In a site size of 300, TriageHF Plus was predicted to prevent 384 (363-405) hospitalisations over 5 years. In total, TriageHF Plus saved £3989 (£1812-£5563) per person-lifetime versus usual care and was more effective and cost-saving in 99.4% of simulations. Results were robust to changes in key input parameters. Modelling showed that to avoid one hospitalisation, 1.7 people would need lifetime access to TriageHF Plus. CONCLUSION: The TriageHF Plus pathway is cost-effective for the remote monitoring of HF in patients with CIEDs. TRIAL REGISTRATION NUMBER: NCT04177199.