Résumé
To evaluate the cost-effectiveness of connected monitoring (remote telemonitoring) of patients with rheumatoid arthritis (RA) starting a new synthetic or biological disease-modifying antirheumatic drug (DMARD) compared to conventional monitoring in physical consultations. Methods: a medico-economic evaluation based on a randomised controlled trial of 89 patients was performed. Patients in the intervention group (n = 45) were monitored using a smartphone-connected interface, while patients in the control group (n = 44) were monitored conventionally. Health outcomes were measured as a gain in quality-adjusted life years (QALYs), assessed using the EQ-5D questionnaire. Data on healthcare consumption and health outcomes were collected throughout the trial over a six-month period from app data, project manager time, medical visits, hospitalisations and transport records. These results were valued on unit costs and QALY weights. An extended sensitivity analysis was performed to examine the robustness of the results. Results: compared to patients monitored conventionally, patients with connected monitoring obtained a slightly higher average gain of 0.07 QALYs. The economic analysis showed that connected monitoring resulted in a significant cost reduction of €72 (€2,927 versus €2,999; p<0.01). The incremental cost-utility ratio of the intervention was equal to -€1,029 per QALY (95% CI: -€32,033; +€24,625) with a 97.8% chance of being cost-effective at a threshold of €30,000 per QALY gained. Conclusion: connected monitoring in patients with RA starting a background treatment with DMARD is more effective and less costly than conventional monitoring.