PATIENT HETEROGENEITY IN COST-EFFECTIVENESS MODELS FOR CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)- ARE CURRENT MODELS SUITABLE TO EVALUATE PERSONALIZED MEDICINE

Author(s)

Hoogendoorn M¹, Feenstra T², Asukai Y³, Briggs A⁴, Borg S⁵, dal Negro R⁶, Hansen RN⁷, Jansson S⁸, Wacker M⁹, Risebrough N¹⁰, Samyshkin Y³, Leidl R⁹, Rutten van-Mölken M¹
¹Erasmus University Rotterdam, Rotterdam, The Netherlands, ²RIVM /UMCG, Bilthoven, The Netherlands, ³IMS Health, London, UK, ⁴University of Glasgow, Glasgow, UK, ⁵Lund University, Lund, Sweden, ⁶National Center for Respiratory Pharmacoeconomics & Pharmacoepidemiology, Verona, Italy, ⁷University of Washington, Seattle, WA, USA, ⁸The OLIN Studies, Luleå, Sweden, ⁹Helmholtz Zentrum Munchen, Neuherberg, Germany, ¹⁰ICON plc, Toronto, ON, Canada

OBJECTIVES: To assess how suitable current COPD cost-effectiveness models are to evaluate personalized treatment options for COPD by exploring the type of heterogeneity included in current models and by validating outcomes for subgroups of patients. METHODS: A consortium of COPD modelling groups participated in three evaluations. First, they reported all patient characteristics included in the model and provided the level of detail in which the input parameters were specified. Second, groups simulated disease progression, mortality, QALYs and costs for hypothetical subgroups of patients that differed in gender, age, smoking status and FEV1% predicted. Finally, model outcomes for exacerbations and mortality for subgroups of patients were validated against published subgroup results of two large COPD trials. RESULTS: Nine COPD modelling groups participated. Most models included gender (7), age (9), smoking status (6) and FEV1% predicted (9), mainly to specify disease progression and mortality. Almost all input parameters were specified by FEV1% predicted. In addition, disease progression was higher for females and smokers in three and five models, respectively and costs were higher for older patients in three models. Differences between subgroups on other parameters were more variable between the models. Trial results showed higher exacerbation rates for females, which was found in one model, higher mortality rates for males (found in two models), lower mortality for younger patients (found in four models), and higher exacerbation and mortality rates in severe COPD compared to moderate COPD patients (found in four models). CONCLUSIONS: The majority of currently available COPD cost-effectiveness models are able to evaluate the cost-effectiveness of personalized treatment based on gender, age, smoking and FEV1% predicted. Treatment in COPD is however, more likely to be personalized based on clinical parameters. Two models include several clinical patient characteristics and seem most suitable to evaluate personalized treatment, although some important clinical parameters are still missing.

Conference/Value in Health Info

2015-11, ISPOR Europe 2015, Milan, Italy

Value in Health, Vol. 18, No. 7 (November 2015)

Code

PRM69

Topic

Methodological & Statistical Research

Topic Subcategory

Modeling and simulation

Disease

Respiratory-Related Disorders

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