Impact of Mucus Plugs on the Health Economic Burden in Chronic Obstructive Pulmonary Disease (COPD) Patients
Author(s)
Juan Pablo Castiblanco Salgado, MPH1, Josefine Persson, PhD1, Lise Retat, MSc2, Suzan Serip, BSc2, Mikael Svensson, PhD3.
1AstraZeneca, Gothenburg, Sweden, 2AstraZeneca, Barcelona, Spain, 3University of Gothenburg, Gothenburg, Sweden.
1AstraZeneca, Gothenburg, Sweden, 2AstraZeneca, Barcelona, Spain, 3University of Gothenburg, Gothenburg, Sweden.
OBJECTIVES: Airway mucus plugs are common in COPD patients and associated with increased mortality, frequent exacerbations, and poor quality of life (QOL). This study estimated the health-related QOL and economic impact of reducing mucus plugs in COPD patients.
METHODS: A Markov cohort model was developed to evaluate the cost-effectiveness of a hypothetical intervention aimed solely at reducing mucus plugs in COPD patients. The model features 1-month cycles and four health states: three representing lung segment mucus plug scores (0, 1-2, and ≥3), and death. The model used a lifetime horizon from a UK national healthcare perspective and compared standard-of-care against three scenarios (hypothetical interventions that reduced mucus plugs by 25%, 50%, and 75%). Baseline characteristics for the simulated cohort were derived from the COPDGene study; standard-of-care transition probabilities were based on published data. The hypothetical intervention was priced based on drug acquisition costs for a biologic for COPD, currently under evaluation by NICE. Two-way (75% reductions in drug acquisition costs and mucus plugs) and deterministic sensitivity analyses were conducted.
RESULTS: Compared with standard-of-care, an intervention to reduce mucus plugs by 50% generated quality-adjusted life-year (QALY) gains of 0.50, an incremental cost of £63,213, and saved £1,613 in exacerbation- and disease management-related healthcare costs. The incremental cost-effectiveness ratio (ICER) was £126,249/QALY in the base case and £27,338/QALY in the two-way sensitivity analysis. Deterministic sensitivity analysis indicated that drivers of ICERs were drug acquisition costs, and the incidence of exacerbations and mortality rate in patients with 0 mucus plugs.
CONCLUSIONS: In this model, a hypothetical intervention to reduce mucus plugs generated healthcare cost savings and QALY gains. These results address a gap in current health economic models and suggest that mucus plug reduction should be included in cost-effectiveness analyses to accurately assess the potential clinical and economic benefit of biologics for COPD.
METHODS: A Markov cohort model was developed to evaluate the cost-effectiveness of a hypothetical intervention aimed solely at reducing mucus plugs in COPD patients. The model features 1-month cycles and four health states: three representing lung segment mucus plug scores (0, 1-2, and ≥3), and death. The model used a lifetime horizon from a UK national healthcare perspective and compared standard-of-care against three scenarios (hypothetical interventions that reduced mucus plugs by 25%, 50%, and 75%). Baseline characteristics for the simulated cohort were derived from the COPDGene study; standard-of-care transition probabilities were based on published data. The hypothetical intervention was priced based on drug acquisition costs for a biologic for COPD, currently under evaluation by NICE. Two-way (75% reductions in drug acquisition costs and mucus plugs) and deterministic sensitivity analyses were conducted.
RESULTS: Compared with standard-of-care, an intervention to reduce mucus plugs by 50% generated quality-adjusted life-year (QALY) gains of 0.50, an incremental cost of £63,213, and saved £1,613 in exacerbation- and disease management-related healthcare costs. The incremental cost-effectiveness ratio (ICER) was £126,249/QALY in the base case and £27,338/QALY in the two-way sensitivity analysis. Deterministic sensitivity analysis indicated that drivers of ICERs were drug acquisition costs, and the incidence of exacerbations and mortality rate in patients with 0 mucus plugs.
CONCLUSIONS: In this model, a hypothetical intervention to reduce mucus plugs generated healthcare cost savings and QALY gains. These results address a gap in current health economic models and suggest that mucus plug reduction should be included in cost-effectiveness analyses to accurately assess the potential clinical and economic benefit of biologics for COPD.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE537
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)