An economic model of the impact of digital medicines with a mobile application in patients with comorbid hypertension, diabetes, and hypercholesterolemia

Abstract

Objectives: There is a strong correlation between cardiovascular disease and diabetes with management of blood pressure (BP), blood glucose (BG), and lipids being essential to preventing disease progression and complications. The FDA-cleared Proteus device captures and shares information about medication-taking, rest and activity patterns through a mobile device and app, a patch with a wearable sensor inside, and sensor-enabled pills. This offering facilitates patient engagement and behavioral change, informative provider decision-making, and improvement of outcomes. An economic model was developed to estimate the impact of reducing BP, BG, and lipids via the Proteus offering. Methods: The value of 1-month use of the Proteus offering to reduce BP, BG, and lipids was evaluated in patients with comorbid hypertension, type 2 diabetes, and hypercholesterolemia from a US payer perspective for a 1-year time horizon. The clinical and utilization assumptions were derived from the literature, expert opinion, and a real-world Proteus study in patients with uncontrolled hypertension. Costs were derived from the Medicare Fee Schedule and AHRQ databases. Payers were also interviewed for current management of these conditions as input to the model. Results: The cost offsets of the Proteus service offering were estimated to be $90-185 per month of use, including current reimbursement for medications and medication adherence solutions. Medical cost savings consisting of reductions in outpatient and inpatient services, monitoring, disease management, and medication costs were estimated to be $850-980 per patient per year (PPPY), which was mainly driven by a 5-11% reduction in diabetes and CVD complications. Revenue opportunities via meeting quality measures presented an additional value equating to $80-95 PPPY, bringing the total value of the Proteus offering to $1020-1260 PPPY. Conclusions: The Proteus offering provides opportunities to mitigate the high costs of managing at-risk patients with multiple cardiometabolic comorbidities.