Abstract
Background: Active Steps (AS) is a telephone-based health coaching intervention developed to support inactive adults with chronic lung conditions to become and stay physically active.
Aim: To conduct an economic evaluation of AS.
Method: Incremental analysis was used to compare, in 2018-19 prices, AS to standard care (independent control, IC) for adults with chronic lung conditions from the perspective of the National Health Service (NHS) and personal social services in the UK. Two instruments were used over a 12-month period to collect economic data: EQ-5D-5L and a bespoke questionnaire designed to elicit usage of NHS resources. Quality adjusted life years (QALY) were calculated using area under the curve. Interest lies with the use of AS targeted to patients functionally disabled by breathlessness and awaiting pulmonary rehabilitation, indicated by MRC Dyspnoea grade 3 or higher.
Results:
Aggregate cost (£) |
Costed years |
Total cost (£ pp) |
Total QALY |
Life Years |
QALY (pp) |
ICER (£/QALY) | |
AS (n=63) | 68,403 | 29.9 | 2,290 | 21.1 | 38.3 | 0.55 | |
IC ( n=51) | 83,809 | 38.7 | 2,168 | 20.9 | 40.0 | 0.52 | |
Difference | 122 | 0.03 | 4,274 |
In patients with MRC Dyspnoea 3-5, AS improves health but does so at increased cost to the NHS. Implementing AS is expected to be cost-effective against standard care provided the NHS is prepared to pay at least £4,274 to achieve an additional year of full health. Incorporating uncertainty, at a willingness to pay threshold of £10,000 per QALY there is a 58% chance that AS will be cost-effective over standard care.
Conclusion: Active Steps can be cost-effective against standard care provided it is delivered to adults with chronic lung conditions who consider themselves to be functionally disabled by breathlessness.
Footnotes
Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA2115.
This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2021