Potential cost savings by telemedicine-assisted long-term care of implantable cardioverter defibrillator recipients

Home monitoring (HM) of cardioverter defibrillators (ICD) with its automated wireless remote data access, may decrease the rate of patient visits. This study examined the potential cost savings for the long-term care of ICD assisted by HM. A French database including 502 patients from 6 university hospitals was used. Costs of conventional follow-up (FU) of ICD were calculated without, and compared with the expected cost of FU with HM. Calculations included number of visits, including physician's fees, electrocardiograms, and. specific ICD surveillance, and transportation costs. The mean distance between home and institutions performing follow-ups was 69 +/- 57 km. For each visit, a mean overall cost of $215 was calculated, including $121 for transportation and $94 for medical services. HM may obviate up to 2 visits per year. Over the 5 years of expected life of the device, the decrease in costs for FU visits was estimated at $2,149. With an additional cost of $1,200 for the HM system, saving began after a mean FU of 33.5 months. The time to onset of cost saving by HM ranged between 17.4 months for patients living >150 km from the medical facility to 52.2 months for those living <50 km away. It is concluded that the HM may considerably reduce the overall costs of ICD FU by saving on transportation cost, particularly when the distance between home and medical facility is >100 km.