Cost-effectiveness of implementing a home blood pressure telemonitoring program.

The home blood pressure telemonitoring (HBPT) program achieved modest but statistically significant reductions in diastolic blood pressure and a borderline significant reduction in systolic blood pressure.

• Mean systolic BP reduction was 1.42 mm Hg (P = .071)
• Mean diastolic BP reduction was 1.58 mm Hg (P = .001)
• Study included 3067 patients with mean age 56.7 years, 62.7% female, and 62.1% non-Hispanic Black
• A difference-in-differences analysis was used to estimate mean differences in outcomes associated with the HBPT program
• Patients were enrolled in the Kaiser Permanente Southern California HBPT program from November 2019 to June 2022

The incremental cost-effectiveness ratios for the HBPT program were $81.67 per mm Hg systolic BP reduction and $73.22 per mm Hg diastolic BP reduction.

• Incremental cost-effectiveness ratios (ICERs) were calculated as cost per mm Hg reduction with 95% bootstrapped CIs
• ICER for systolic BP reduction was $81.67 per mm Hg
• ICER for diastolic BP reduction was $73.22 per mm Hg
• Costs were measured in 2020 US dollars

HBPT program implementation costs averaged $113.35 per patient.

• Program implementation costs were estimated alongside hypertension-related health care utilization and costs
• Costs were analyzed over 12 months pre- and post-HBPT program enrollment
• Overall costs increased primarily due to enrollment expenses

The HBPT program reduced hypertension-related office visit costs and BP clinic visit costs, but increased hypertension-related virtual encounter costs.

• Hypertension-related office visit costs were reduced by -$6.52 (P = .016)
• BP clinic visit costs were reduced by -$2.58 (P = .002)
• Hypertension-related virtual encounter costs increased by $11.80 (P < .001)
• Net effect was an overall increase in costs despite reductions in in-person visit costs

The study used inverse probability of treatment weights to compare outcomes between HBPT program participants and patients who abandoned the program prior to participation.

• Patients who abandoned the program prior to participation served as the comparator group
• Inverse probability of treatment weights were applied to adjust for baseline characteristics
• A difference-in-differences analysis was used to estimate mean differences in outcomes
• The retrospective cohort study analyzed data from a large US integrated health care system (Kaiser Permanente Southern California)