Health technology assessment of the remote monitoring of patients with implanted cardiac devices by KCE in Belgium

On November 9, 2021, the Belgian Health Care Knowledge Center (KCE) published the health technology assessment report "Remote monitoring of patients with cardiovascular implantable electronic devices (CIED)". The aim of the report was to summarize the existing clinical and economic evidence on the remote monitoring of patients with CIEDs, i.e., implantable cardioverter-defibrillators (ICDs), pacemakers (PMs), cardiac resynchronization therapy devices with only pacemaker function (CRT-P), cardiac resynchronization therapy devices with a defibrillator function (CRT-D), and implantable loop recorders (ILRs), and to investigate reimbursement practices in other countries in order to provide recommendations for potential reimbursement of these technologies.

Analysis of efficacy and safety of remote monitoring showed the following advantages for the patients, i.e., a 'protocol-based' reduction of in-clinic visits, earlier detection of events, reduced risk of inappropriate shocks, and a lower burden of atrial arrhythmias, but, overall, there was no significant effect of remote monitoring on their health-related quality of life, hospitalizations, or mortality.

Cost-effectiveness analysis indicates that remote cardiac monitoring of ICDs and PMs is cost-effective compared to monitoring exclusively based on in-clinic visits. No relevant studies were identified for ILRs. The cost-effectiveness of remote monitoring for Belgium could not be investigated due to the lack of Belgian-specific data.

Except for efficacy, safety, and cost-effectiveness, reimbursement and organizational aspects for remote monitoring in France, the Netherlands, and Germany, and potential financing models for Belgium, as well as a budget impact, were analyzed.

The full details in English can be found here.

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