OBJECTIVES

: This study screened undiagnosed and untreated COPD patients among rural residents in northern China and performed a health economic assessment to demonstrate the cost-effectiveness of screening program. These results will be helpful to find more early-stage COPD patients, hence achieve early intervention and treatment.

METHODS

: The data was collected from the screening program for COPD at Fengning Manchu Autonomous County, Hebei province. The smokers aged over 45 years old or passive smokers, the patients with lung disease, or family history of lung disease, or with respiratory symptom were enrolled in the screening program. The COPD-PS questionnaire score is over 5 and spirometer testing result of FEV1/FVC is lower than 0.7, then COPD patients confirmed. We used a published cost-effectiveness model to validate our result (the model has been accepted by NPJ Primary Care Respiratory Medicine), The model was developed using a decision tree and Markov model, simulating the disease progression after screening program. Incremental cost per quality-adjusted life years (ICER) was compared between high-risk patients receiving screening and not receiving screening. The model ran over a 15 year and monthly cycle. Both one-way and probabilistic sensitivity analysis were performed to assess the robustness of the result.

RESULTS

: Total of 700 questionnaires were distributed in the screening program, and 379 were effective eventually. 92 COPD patients have been confirmed (24.27%), including 51 mild cases, 22 moderate cases and 19 severe cases. The model results demonstrated that screening program was cost-saving compared with no screening, with the incremental QALY of 0.28 QALY, and incremental cost of ¥6366.19 per QALY, which is far lower than the threshold of WTP of ¥70888.99 (GDP in China per -capital in 2019)

CONCLUSIONS

: Screening program is cost-effective compared with no screening for high-risk COPD patient in China county.