COST-EFFECTIVENESS OF CASE DETECTION STRATEGIES FOR THE EARLY DETECTION OF COPD

Author(s)

Johnson K1, Sadatsafavi M2, Adibi A2, Lynd LD2, Harrison M2, Tavakoli H2, Sin D2, Bryan S2
1University of Washington, Seattle, WA, USA, 2University of British Columbia, Vancouver, BC, Canada

OBJECTIVES : The value of early detection and treatment of chronic obstructive pulmonary disease (COPD) is currently unknown. We assessed the cost-effectiveness of various primary care-based case detection strategies for COPD.

METHODS : A previously validated discrete event simulation model of the general population of COPD patients in Canada was used to assess the cost-effectiveness of 16 case detection scenarios. In these scenarios, eligible patients (based on age, smoking history, or symptoms) received the COPD Diagnostic Questionnaire (CDQ) or screening spirometry, at 3- or 5-year intervals, during routine visits to a primary care physician. Newly diagnosed patients received treatment for smoking cessation and guideline-based inhaler pharmacotherapy. Analyses were conducted over a 20-year time horizon from the healthcare payer perspective. Costs are reported in 2015 Canadian dollars ($). Key treatment parameters were varied in one-way sensitivity analysis.

RESULTS : Compared to no case detection, all 16 case detection scenarios had an incremental cost effectiveness ratio (ICER) below a $50,000/QALY willingness to pay threshold in the reference case analysis. In the most efficient scenario, all patients ≥40 years received the CDQ at 3-year intervals. This scenario was associated with an incremental cost of $180 per eligible patient, and an incremental effectiveness of 0.009 QALYs per eligible patient, resulting in an ICER of $21,108/QALY compared to the CDQ delivered to ever smokers at 5-year intervals, which was the next most highly-ranked scenario on the efficiency frontier. Results were most sensitive to the impact of treatment on the symptoms of newly diagnosed patients. When this was not associated with a utility benefit, case detection was no longer cost-effective.

CONCLUSIONS : Primary care-based case detection programs for COPD are likely to be cost-effective if adherence to best-practice recommendations for treatment is high.

Conference/Value in Health Info

2020-05, ISPOR 2020, Orlando, FL, USA

Code

PRS17

Topic

Economic Evaluation, Health Service Delivery & Process of Care, Medical Technologies, Methodological & Statistical Research

Topic Subcategory

Diagnostics & Imaging, Disease Management, Modeling & Simulation

Disease

Respiratory-Related Disorders

Your browser is out-of-date

ISPOR recommends that you update your browser for more security, speed and the best experience on ispor.org. Update my browser now

×