Economic Evaluation of Community-Based Case Management of Patients Suffering From Chronic Obstructive Pulmonary Disease

Bidragets oversatte titel: Økonomisk evaluering af kommunlt forankret forløbskoordination til patienter med kronisk obstruktiv lungesygdom (KOL)

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

5 Citationer (Scopus)

Abstrakt

Objectives
To analyse the cost effectiveness of community-based case management for patients suffering from chronic obstructive pulmonary disease (COPD).

Methods
The study took place in the third largest municipality in Denmark and was conducted as a randomised controlled trial with 12 months of follow-up. A total of 150 patients with COPD were randomised into two groups receiving usual care and case management in addition to usual care. Case management included among other things self care proficiency, medicine compliance, and care coordination. Outcome measure for the analysis was the incremental cost-effectiveness ratio (ICER) as cost per quality-adjusted life year (QALY) from the perspective of the healthcare sector. Costs were valued in British Pounds (£) at price level 2016. Scenario analyses and probabilistic sensitivity analyses were conducted in order to assess uncertainty of the ICER estimate.

Results
The intervention resulted in a QALY improvement of 0.0146 (95% CI −0.0216; 0.0585), and a cost increase of £494 (95% CI −1778; 2766) per patient. No statistically significant difference was observed either in costs or effects. The ICER was £33,865 per QALY gained. Scenario analyses confirmed the robustness of the result and revealed slightly lower ICERs of £28,100–£31,340 per QALY.

Conclusions
Analysis revealed that case management led to a positive incremental QALY, but were more costly than usual care. The highly uncertain ICER somewhat exceeds for instance the threshold value used by the National Institute of Health and Care Excellence (NICE). No formally established Danish threshold value exists.
Bidragets oversatte titelØkonomisk evaluering af kommunlt forankret forløbskoordination til patienter med kronisk obstruktiv lungesygdom (KOL)
OriginalsprogEngelsk
TidsskriftApplied Health Economics and Health Policy
Vol/bind15
Udgave nummer3
Sider (fra-til)413-424
Antal sider12
ISSN1175-5652
DOI
StatusUdgivet - 15 maj 2017

Emneord

  • Forløbskoordination
  • Omkostningseffektivitet
  • Cost-utility
  • Kronisk obstruktiv lungesygdom

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