Kim Jung Hyun, Shin Jaeyong, Kim Man S, Moon Jae Hoon
Division of Tourism and Wellness, Hankuk University of Foreign Studies, 81 Oedae-ro, Mohyeon-eup, Cheoin-gu, Yongin, 17035, Republic of Korea.
Institute for Innovation in Digital Healthcare, Yonsei University Health System, Seoul, Republic of Korea.
JMIR Mhealth Uhealth. 2025 Jul 22;13:e56738. doi: 10.2196/56738.
The integration of wearable technology for heart rate monitoring offers potential advancements in managing hyperthyroidism by providing a feasible way to track thyroid function. Although digital health solutions are gaining traction in various chronic conditions, their cost-effectiveness in hyperthyroidism management requires deeper investigation.
This study aimed to evaluate the cost-effectiveness of a wearable or mobile-based thyroid function digital monitoring solution for hyperthyroidism management and to make a comparison with the existing standard approach within the South Korean health care context.
We developed a decision-analytic Markov microsimulation model to simulate the cost and effectiveness of digital monitoring in a cohort of 10,000 hypothetical hyperthyroidism patients aged 40 years. The analysis was conducted from the perspective of the health care system, with a 4.5% annual discount rate applied to costs and effectiveness and an inflation adjustment to 2022 values. Model inputs were sourced from clinical studies, publicly available datasets, and expert input, with outcomes measured in quality-adjusted life years (QALYs). Cost-effectiveness was evaluated through incremental cost-effectiveness ratios (ICERs) and net monetary benefits (NMB), with additional deterministic and probabilistic sensitivity analyses performed to address input uncertainties.
Integrating digital monitoring yielded an additional 0.32 QALYs per patient at an incremental cost of US $3143, resulting in an ICER of US $9804.30 per QALY, significantly below the South Korean willingness-to-pay threshold of US $32,255/QALY. The digitally supported group exhibited improved rates of long-term remission (22.68%, 2268/10,000) and reduced postremission relapse (17.87%, 1787/10,000) compared to standard care (17.48%, 1748/10,000 and 26.37%, 2637/10,000, respectively). Probabilistic sensitivity analysis showed that digital intervention was the preferred cost-effective strategy in 64.4% (6440/10,000) of iterations. Subscription costs of the digital platform and the utility weight for thyroid-associated orbitopathy emerged as key factors affecting the ICER in sensitivity analyses.
The findings suggest that digital monitoring provides a cost-effective strategy for enhancing hyperthyroidism management, supporting sustained remission, and reducing relapse rates. As such, digital solutions could serve as a valuable adjunct to traditional care, with the cost-effectiveness analysis providing an economic basis for determining pricing and value-based reimbursement in health care systems. The study underscores the importance of integrating digital solutions in chronic disease management and suggests that further research should include societal costs, such as productivity, to capture economic benefits fully.
可穿戴技术用于心率监测的整合，通过提供一种可行的方式来跟踪甲状腺功能，为甲亢管理带来了潜在进展。尽管数字健康解决方案在各种慢性病中越来越受到关注，但其在甲亢管理中的成本效益需要更深入的研究。
本研究旨在评估用于甲亢管理的可穿戴或基于移动设备的甲状腺功能数字监测解决方案的成本效益，并在韩国医疗保健背景下与现有标准方法进行比较。
我们开发了一个决策分析马尔可夫微观模拟模型，以模拟在10000名假设的40岁甲亢患者队列中数字监测的成本和效果。分析是从医疗保健系统的角度进行的，成本和效果采用4.5%的年贴现率，并对2022年的值进行通胀调整。模型输入来自临床研究、公开可用数据集和专家意见，结果以质量调整生命年（QALYs）衡量。通过增量成本效益比（ICERs）和净货币效益（NMB）评估成本效益，并进行额外的确定性和概率敏感性分析以解决输入不确定性问题。
整合数字监测使每位患者额外获得0.32个QALYs，增量成本为3143美元，导致ICER为每QALY 9804.30美元，显著低于韩国每QALY 32255美元的支付意愿阈值。与标准护理相比（分别为17.48%，1748/10000和26.37%，2637/10000），数字支持组的长期缓解率提高（22.68%，2268/10000），缓解后复发率降低（17.87%，1787/10000）。概率敏感性分析表明，在64.4%（6440/10000）的迭代中，数字干预是首选的成本效益策略。数字平台的订阅成本和甲状腺相关眼病的效用权重在敏感性分析中成为影响ICER的关键因素。
研究结果表明，数字监测为加强甲亢管理、支持持续缓解和降低复发率提供了一种具有成本效益的策略。因此，数字解决方案可以作为传统护理的有价值辅助手段，成本效益分析为医疗保健系统确定定价和基于价值的报销提供了经济依据。该研究强调了在慢性病管理中整合数字解决方案的重要性，并建议进一步的研究应包括社会成本，如生产力，以充分捕捉经济效益。
