Costs and resource use

Economic evidence

No published economic evidence was found.

Technology costs

The GDm‑Health app is free to download. It can only be used with a mobile internet connection, which may incur additional costs to the user.

Table 3 shows the estimated costs of adopting GDm‑Health in an NHS trust. The estimates are uncertain because costs across NHS trusts will vary according to the number of users and healthcare professionals, and whether extra equipment is needed.

Bluetooth- or NFC-compatible blood glucose monitors and mobile devices can be supplied to patients if needed. However, such monitors may be standard care in some NHS trusts, and many patients will be able to use their own mobile device.

Table 3 Estimated technology costs

Component

Cost

Details

Compatible mobile device

£10 to £130.

We expect that 95% or more of users will use their own device. The hospital may provide the additional devices if needed

Phone contract

£5 to £10 per month.

Hosting for the secure website

Around £2,000 per year for 7 web-based applications (individual clinic systems)

£1,143 per year for the current 4 clinics

The website is currently hosted by the Oxford University Hospitals NHS Foundation Trust virtual server facility, which incurs all costs

Security certificate.

£300 every 3 years

App and website maintenance

Around £41,340 per year

0.5 WTE band 7 scientist (795 hours per year at £52 per hour)

Based on an hourly cost of £52 for band 7 community-based scientific staff (PSSRU, 2016)

Comparator costs

People with gestational diabetes attend an outpatient clinic every 2 weeks during their third trimester, providing written details of blood glucose measurements in person or by email.

The NICE guideline on diabetes in pregnancy has a supplementary costing statement, which outlines the standard care per-patient costs for monitoring pregnant people with type 2 and gestational diabetes. According to the costing statement, the total cost for monitoring is £386.48 per patient.

Potential resource impact

GDm‑Health is intended to reduce the frequency of face-to-face appointments, not replace them altogether. Most standard care costs will still be incurred with the use of GDm‑Health, but users may need fewer appointments than people having standard care.

Adopting GDm‑Health may need changes to local protocols for managing gestational diabetes. These could include introducing protocols for responding to users, remote monitoring, communication between users and other members of the healthcare team, training and data storage, and management and security. Implementing and managing GDm‑Health may need additional staff, such as project management. As a result, the roles of the lead midwife or diabetic specialist nurse may need to change to reflect less face-to-face contact with patients, but more contact through SMS text messages.

Using GDm‑Health standardises the way patients record their measurements. Midwives can respond in real time instead of potentially having to wait for data by email. This could lead to shorter face-to-face appointments for users, and therefore less resource use.

There are 4 NHS trusts using the system, at an approximate cost to the Oxford University Hospitals NHS Foundation Trust of £42,583 per year. Based on the costs of standard care, using GDm‑Health could save approximately £230 per patient by reducing the need for additional appointments.