Sleepio: real-world evaluation and NICE assessment of a digital health technology

April 21, 2021
Edmonton, Alberta

Sleepio is an automated digital programme that delivers cognitive behavioural therapy for insomnia. Sleepio is effective in improving sleep difficulties and was recently submitted for assessment as part of the National Institute for Health and Care Excellence (NICE) Medical Technologies Evaluation Programme (MTEP). We assessed the effect of a population-wide rollout of Sleepio on primary care costs in the National Health Service (NHS) in England. These findings informed the economic assessment for MTEP. This presentation will summarise the empirical work and its use in a novel NICE assessment process.

The study was conducted in the Thames Valley region of England, where access to Sleepio was made freely available to all residents between October 2018 and January 2020. We used primary care data for people with relevant characteristics from nine general practices in Buckinghamshire. The study relies on a quasi-experimental design, using an interrupted time series to compare the trend in primary care costs before and after the rollout of Sleepio. Primary care costs include general practice contacts and prescriptions. Segmented regression analysis was used to estimate primary and secondary outcomes. Information on uptake and engagement were collected through the Sleepio app. We used these data to construct a budget impact model and to populate NICE’s economic modelling template.

For the 10,704 patients included in our sample, the total saving over the 65-week follow-up period was £71,027. This corresponds to £6.64 per person in our sample or around £70.44 per Sleepio user. Secondary analyses suggest that savings may be driven primarily by reductions in prescriptions. National adoption of Sleepio may reduce primary care costs by £20 million in the first year. The economic model shows an overall cost-saving and is currently under consideration by NICE. The impact on primary care costs in any setting will depend on the uptake of Sleepio.

Sleepio: real-world evaluation and NICE assessment of a digital health technology

Presenter

Chris Sampson, Principal Economist, Office of Health Economics