RT Journal Article
SR Electronic
T1 Is INTERdisciplinary COMmunity-based COPD management (INTERCOM) cost-effective?
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 79
OP 87
DO 10.1183/09031936.00043309
VO 35
IS 1
A1 M. Hoogendoorn
A1 C. R. van Wetering
A1 A. M. Schols
A1 M. P. M. H. Rutten-van Mölken
YR 2010
UL http://erj.ersjournals.com/content/35/1/79.abstract
AB The study aimed to estimate the cost-effectiveness of interdisciplinary community-based chronic obstructive pulmonary disease (COPD) management in patients with COPD. We conducted a cost-effectiveness analysis alongside a 2-yr randomised controlled trial, in which 199 patients with less advanced airflow obstruction and impaired exercise capacity were assigned to the INTERCOM programme or usual care. The INTERCOM programme consisted of exercise training, education, nutritional therapy and smoking cessation counselling offered by community-based physiotherapists and dieticians and hospital-based respiratory nurses. All-cause resource use during 2 yrs was obtained by self-report and from hospital and pharmacy records. Health outcomes were the St George's Respiratory Questionnaire (SGRQ), exacerbations and quality-adjusted life years (QALYs). The INTERCOM group had 30% (95% CI 3–56%) more patients with a clinically relevant improvement in SGRQ total score, 0.08 (95% CI -0.01–0.18) more QALYs per patient, but a higher mean number of exacerbations, 0.84 (95% CI -0.07–1.78). Mean total 2-yr costs were €2,751 (95% CI -€632–€6,372) higher for INTERCOM than for usual care, which resulted in an incremental cost-effectiveness ratio of €9,078 per additional patient with a relevant improvement in SGRQ or €32,425 per QALY. INTERCOM significantly improved disease-specific quality of life, but did not affect exacerbation rate. The cost per QALY ratio was moderate, but within the range of that generally considered to be acceptable.