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Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease
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Cost-Effectiveness of a Community-Based Exercise Programme in COPD Self-Management.

Marlies Zwerink1, Tanja Effing2,3, Huib A M Kerstjens4

  • 1a 1 Medisch Spectrum Twente , Department of Pulmonary Medicine , Enschede , the Netherlands.

COPD
|December 2, 2015
PubMed
Summary

A community-based exercise program for COPD patients was not cost-effective over two years due to waning benefits and higher costs. However, it showed acceptable cost-effectiveness for improving physical activity and quality-adjusted life years (QALYs).

Keywords:
COPDcommunity-basedcost-effectivenessexercisephysical activityself-management

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Area of Science:

  • Pulmonary Rehabilitation
  • Health Economics
  • Chronic Obstructive Pulmonary Disease (COPD) Management

Background:

  • Limited data exists on the cost-effectiveness of community-based exercise programs for COPD.
  • This study addresses the economic viability of such programs as part of COPD self-management.

Purpose of the Study:

  • To investigate the cost-effectiveness of a community-based exercise program compared to self-management alone for COPD patients.
  • To evaluate outcomes after a 2-year follow-up period.

Main Methods:

  • A decision analytical model with a 24-month perspective was employed.
  • Cost-effectiveness was assessed using Incremental Cost-Effectiveness Ratios (ICERs) and cost-effectiveness planes.
  • Patients received either self-management sessions plus an 11-month exercise program or self-management sessions only.

Main Results:

  • The Incremental Cost-Effectiveness Ratio (ICER) for preventing deterioration in exercise capacity was €6257.
  • The ICER for achieving clinically relevant improvements in physical activity (≥ 500 steps/day) was €1564.
  • The ICER for an additional quality-adjusted life year (QALY) gained was €10,950.

Conclusions:

  • The community-based exercise program was not cost-effective for COPD due to a lack of sustained exercise capacity benefits and increased costs.
  • Acceptable cost-effectiveness was observed for secondary outcomes including physical activity and QALYs.