WSD results show telehealth not cost effective for chronic disease
22 March 2013
Results from the Whole System Demonstrator Trial, one of the
largest trials of telecare and telehealth ever conducted, show that
telehealth does not seem to be cost effective for supporting
treatment for patients with long term conditions.
The findings, published on bmj.com, follow a BMJ study published
last month showing that telehealth does not improve quality of life
for patients with long term conditions. This is significant because
in December 2011 the UK government used preliminary results from the
WSD Trial to justify launching the 3millionlives campaign to promote
the use of telehealth in the UK.
Telehealth uses technology to help people with health problems
live more independently at home. For example, blood pressure or
blood glucose levels can be measured at home and electronically
transmitted to a health professional, reducing the need for hospital
visits. It is increasingly being promoted in developed countries as
a means to reduce the escalating costs of managing chronic diseases
for health and social services.
Many studies have forecast that health services will be unable to
cope with the incidence of chronic diseases unless more
cost-efficient means are found for management of patients.
Telehealth has been promoted to reduce healthcare costs while
improving health related quality of life, but there is very little
good quality evidence on the effect of telehealth on service use and
So a team of UK researchers examined the costs and cost
effectiveness of telehealth compared with usual care over 12 months
in 965 patients with a long term condition (heart failure, COPD or
diabetes), as part of the Whole Systems Demonstrator Trial.
Of the 965 patients, 534 received telehealth equipment and
support, while 431 received usual care. The results took account of
costs to both health and social care systems.
The cost per quality adjusted life year (QALY) — a combined
measure of quantity and quality of life — of telehealth when added
to usual care was £92,000. This is well above the cost effectiveness
threshold of £30,000 set by the UK National Institute for Health and
Clinical Excellence (NICE). The probability of cost effectiveness
was low (11%).
Even when the effects of equipment price reductions and increased
working capacity of services were combined, the probability that
telehealth is cost effective was only about 61%, at a threshold of
£30 000 per QALY.
The authors say that the QALY gain by people using telehealth in
addition to standard support and treatment was similar to those
receiving usual care, and total costs for the telehealth group were
higher. As such they conclude that “telehealth does not seem to be a
cost effective addition to standard support and treatment.”
The full paper is published on the BMJ at:
See also Chronic Disease management in Europe — going beyond
telemonitoring, by Harry Wood, Editor of MTB Europe, published in