Cost-effectiveness Analysis Comparing Conventional and Digital Software Supported Management for Hypothyroidism

Abstract

Background: Wearable devices can now leverage the established correlation between thyroid function and heart rate to monitor thyroid function alongside exercise levels and heart rate. The objective was to assess the cost-effectiveness of introducing a wearable/mobile-based thyroid function digital monitoring solution for the management of hypothyroidism compared to the conventional management approach. Methods: A decision-analytic Markov state-transition simulation model employed for using a simulated cohort of 10 000 40-year-old patients with hypothyroidism to estimate costs and health outcomes. Cost-effectiveness from the health care sector perspective was evaluated using a 4.5% annual discount rate and the costs adjusted to 2022 levels, and lifetime outcomes were presented through incremental costeffectiveness ratios (ICERs). Deterministic and probabilistic sensitivity analyses evaluated the robustness of the results. Results: The digital monitoring solution supported group yielded an additional 0.65 quality-adjusted life-years (QALYs) with an incremental cost of $11 700.87, resulting in an ICER value of $17 988.97 per QALY gained. Digital-powered software could be an optimal strategy in 99% of iterations against willingness-to-pay thresholds of $32 255/QALY gained. The ICER was most sensitive to the annual cost of a digital monitoring solution for hypothyroidism. Conclusion: The incorporation of the digital monitoring solution has demonstrated positive cost-effectiveness in hypothyroidism management when compared to the standard care. The cost of the digital monitoring solution and its sensitivity are key factors in determining cost-effectiveness. Striking a balance among the cost of digital monitoring support, the precision of hormonal level monitoring, and its effectiveness for the specific group of hypothyroid patients in real-world clinical practice is essential.