Abstract
Background: Bronchial Thermoplasty (BT) has been shown to be effective at reducing asthma exacerbations for patients with severe asthma. However, little is known about its cost effectiveness.
Aim: To evaluate the incremental cost-effectiveness of BT treatment option (a 3-time treatment episode) relative to no BT treatment option for patients with severe asthma.
Methods: We used a Markov model to estimate the costs and quality-adjusted life years (QALYs) gain for severe asthma patients with and without BT treatment. The model simulated transition among three health states (poorly controlled asthma, controlled asthma, and asthma-related death). We populated the model with data on costs and benefits from our study and from the published literature. We calculated costs from the social perspective which include one-time cost of BT treatment and its complications, costs of subsequent possible hospitalizations as well as costs of work absence.
Results: Over a 10-year time horizon, the average cost per patient is S$44,700 ( €25,690) with BT treatment and S$23,400 (€ 13,448) without BT treatment. The model predicted that the cohort with BT gained 6.28 QALYs per patient while the cohort without BT acquired 5.28 QALYs per patient. The BT treatment delivers incremental cost-effectiveness ratio of S$21,470 (€12,339) per QALY relative to no BT treatment. The findings were robust to probabilistic sensitivity analysis.
Conclusion: Bronchial Thermoplasty with an estimated cost of S$25,000 per treatment episode is cost effective compared with no BT treatment option at the conventional willingness-to-pay level of S$50,000.
- © 2014 ERS
