• Plos One · Jan 2011

    Randomized Controlled Trial

    Cost-effectiveness of Internet-based self-management compared with usual care in asthma.

    • Victor van der Meer, Wilbert B van den Hout, Moira J Bakker, Klaus F Rabe, Peter J Sterk, Willem J J Assendelft, Job Kievit, Jacob K Sont, and SMASHING (Self-Management in Asthma Supported by Hospitals, ICT, Nurses and General Practitioners) Study Group.
    • Department of Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands. v.van_der_meer@lumc.nl
    • Plos One. 2011 Jan 1; 6 (11): e27108.

    BackgroundEffectiveness of Internet-based self-management in patients with asthma has been shown, but its cost-effectiveness is unknown. We conducted a cost-effectiveness analysis of Internet-based asthma self-management compared with usual care.Methodology And Principal FindingsCost-effectiveness analysis alongside a randomized controlled trial, with 12 months follow-up. Patients were aged 18 to 50 year and had physician diagnosed asthma. The Internet-based self-management program involved weekly on-line monitoring of asthma control with self-treatment advice, remote Web communications, and Internet-based information. We determined quality adjusted life years (QALYs) as measured by the EuroQol-5D and costs for health care use and absenteeism. We performed a detailed cost price analysis for the primary intervention. QALYs did not statistically significantly differ between the Internet group and usual care: difference 0.024 (95% CI, -0.016 to 0.065). Costs of the Internet-based intervention were $254 (95% CI, $243 to $265) during the period of 1 year. From a societal perspective, the cost difference was $641 (95% CI, $-1957 to $3240). From a health care perspective, the cost difference was $37 (95% CI, $-874 to $950). At a willingness-to-pay of $50,000 per QALY, the probability that Internet-based self-management was cost-effective compared to usual care was 62% and 82% from a societal and health care perspective, respectively.ConclusionsInternet-based self-management of asthma can be as effective as current asthma care and costs are similar.Trial RegistrationCurrent Controlled Trials ISRCTN79864465.

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