Cost Analysis of Telehealth for Management of Infantile Hemangioma in the United States

Background: Hemangiomas are the most common soft-tissue tumors affecting neonates and rarely lead to complications. Objectives: Assess cost-effectiveness of managing infantile hemangiomas via Telehealth (TH) versus in-person (IP) visits. Methods: Patients with vascular anomalies were assumed to be in 1 of 3 states: infantile hemangioma, nonserious condition, or serious condition. Decision models were constructed for initial and long-term cost of care for patients with infantile hemangiomas. Management was defined as initial visit at 3 months of age with follow-up visits every 3 months until 15 months of age. Reimbursement values were extracted from Medicare data and economic estimates of indirect costs. The expected value of patient visits were calculated in the model, and the lower expected cost was considered optimal. Expected values were calculated under two perspectives: a patient/ payer perspective and a “societal” (patient/payer/provider) perspective, the former assuming TH and IP visits would be equally reimbursed, and the latter incorporating the estimated cost saving arising from lower overhead costs. Deterministic sensitivity analysis was conducted to assess the most salient model inputs. Results: After accounting for increased risk of misdiagnosis and serious conditions, from a patient (payer) perspective, TH was associated with $10.26 cost savings for initial visit, and $51.30 through complete treatment course. From societal perspective TH saved $55.26 initially and $276.30 through complete course. Thus, in comparison to IP, TH is associated with 3.89% and 18.01% cost savings from the payer and societal perspectives, respectively. Conclusion: The use of TH for management infantile hemangioma proved to be cost effective.