Presentation (CTI)

OBJECTIVES: This study aimed to assess the clinical and economic results of implementing organized spirometry screening in primary care settings in Russia among high-risk patients.
METHODS: A decision tree combined with the Markov model was developed to compare the absence of an organized COPD screening program with a scenario involving prebronchodilator portable spirometry screening for individuals aged ≥ 40 with a smoking history. The model was based on Russian epidemiological data, the ARCTIC study data, and national healthcare tariffs. The costs included: the cost of the portable spirometer, the cost of COPD verification, the cost of exacerbation treatment, and production losses. The costs of COPD-supporting therapy and other patient costs were not considered. The time horizon of the research was 10 years. The costs were discounted by 5% annually. The friction cost method was used for the calculation of production losses. Key outcomes included the number of additional diagnosed cases, the number of COPD exacerbations, the LYG, and the ICER per LYG. The analysis was conducted from the healthcare perspective and additionally considered production losses. One-way sensitivity analysis was performed.
RESULTS: The spirometry screening program is expected to prevent 4.9 million exacerbations over 10 years, and save 327,000 person-years of life. It will reduce healthcare costs by 0.1 billion RUB, productivity losses by 21.2 billion RUB, and total costs by 21.3 billion RUB. ICER was not estimated because the program is a dominant strategy. The sensitivity analysis confirmed the robustness of the study results (the range of total cost reduction is 3.9-38.8 billion rubles).
CONCLUSIONS: The implementation of COPD screening program with portable spirometry is a preferable strategy, as it simultaneously improves outcomes and reduces overall costs.