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Is INTERdisciplinary COMmunity-based COPD management (INTERCOM) cost-effective?
M Hoogendoorn1, C R van Wetering, A M Schols
1Institute for Medical Technology Assessment (IMTA), Erasmus MC, Rotterdam, The Netherlands. hoogendoorn@bmg.eur.nl
The European Respiratory Journal
|July 4, 2009
Summary
Interdisciplinary community-based management for chronic obstructive pulmonary disease (COPD) improved quality of life but increased costs. The cost per quality-adjusted life year (QALY) was acceptable, suggesting potential value for COPD patients.
Area of Science:
- Pulmonary Medicine
- Health Economics
- Chronic Disease Management
Background:
- Chronic obstructive pulmonary disease (COPD) management presents significant healthcare challenges.
- Community-based interdisciplinary programs offer a potential solution for improving patient outcomes.
- Evaluating the cost-effectiveness of such programs is crucial for resource allocation.
Purpose of the Study:
- To estimate the cost-effectiveness of an interdisciplinary, community-based COPD management program (INTERCOM).
- To compare the INTERCOM program with usual care in patients with less advanced COPD and impaired exercise capacity.
Main Methods:
- A 2-year randomized controlled trial involving 199 COPD patients.
- The INTERCOM program included exercise training, education, nutritional therapy, and smoking cessation support.
- Cost-effectiveness analysis alongside the trial, measuring resource use, St George's Respiratory Questionnaire (SGRQ) scores, exacerbations, and quality-adjusted life years (QALYs).
Main Results:
- The INTERCOM group showed a 30% higher rate of clinically relevant improvement in SGRQ scores and 0.08 more QALYs per patient.
- Mean 2-year costs were €2,751 higher in the INTERCOM group.
- The incremental cost-effectiveness ratio was €9,078 per relevant SGRQ improvement or €32,425 per QALY.
Conclusions:
- The INTERCOM program significantly improved disease-specific quality of life in COPD patients.
- The program did not significantly affect the exacerbation rate.
- The cost per QALY was moderate and within acceptable ranges, indicating potential value for COPD management.
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