Economic evaluation of a disease management program for chronic obstructive pulmonary disease

Area of Science:

• Health Economics
• Pulmonology
• Clinical Trial Analysis

Background:

• Limited data exists on cost savings associated with disease management (DM) for chronic obstructive pulmonary disease (COPD).
• A recent randomized controlled trial demonstrated that a multicomponent DM program for COPD reduced hospitalizations and emergency department visits compared to usual care (UC).

Purpose of the Study:

• To determine the implementation costs of a multicomponent DM program for COPD.
• To evaluate the impact of the DM program on healthcare resource utilization costs compared to UC in high-risk COPD patients.

Main Methods:

• Post-hoc economic analysis of a 1-year, multicenter, randomized controlled trial.
• Comparison of healthcare costs (hospitalizations, ED visits, medications, DM intervention costs) between DM and UC groups in high-risk COPD patients across 5 VA medical centers.

Main Results:

• Hospitalizations and ED visits were 27% lower in the DM group (123.8 events/100 patient-years) versus the UC group (170.5 events/100 patient-years).
• The DM intervention cost $650 per patient.
• The DM program resulted in an average cost savings of $593 per patient compared to UC, with total costs of $4491 ± $4678 for DM versus $5084 ± $5060 for UC.

Conclusions:

• The multicomponent DM intervention program demonstrated unique cost-effectiveness.
• The program achieved an average cost saving of $593 per patient after accounting for intervention costs.