Developing and Applying a Stochastic Dynamic Population Model for Chronic Obstructive Pulmonary Disease

Dec 1, 2011, 00:00
10.1016/j.jval.2011.06.008
https://www.valueinhealthjournal.com/article/S1098-3015(11)01532-4/fulltext
Title : Developing and Applying a Stochastic Dynamic Population Model for Chronic Obstructive Pulmonary Disease
Citation : https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(11)01532-4&doi=10.1016/j.jval.2011.06.008
First page : 1039
Section Title : Economic Evaluation
Open access? : No
Section Order : 5

Objectives

To develop a stochastic population model of disease progression in chronic obstructive pulmonary disease (COPD) that includes the effects of COPD exacerbations on health-related quality of life, costs, disease progression, and mortality and can be used to assess the effects of a wide range of interventions.

Methods

The model is a multistate Markov model with time varying transition rates specified by age, sex, smoking status, COPD disease severity, and/or exacerbation type. The model simulates annual changes in COPD prevalence due to COPD incidence, exacerbations, disease progression (annual decline in the forced expiratory volume in 1 second as percentage of the predicted value), and mortality. The main outcome variables are quality-adjusted life years, total exacerbations, and COPD-related health care costs. Exacerbation-related input parameters were based on quantitative meta-analysis. All important model parameters are entered into the model as probability distributions. To illustrate the potential use of the model, costs and effects were calculated for 3-year implementation of three different COPD interventions, one pharmacologic, one on smoking cessation, and one on pulmonary rehabilitation using a time horizon of 10 years for reporting outcomes.

Results

Compared with minimal treatment the cost/quality-adjusted life year was €8,300 for the pharmacologic intervention, €10,800 for the smoking cessation therapy, €8,700 for the combination of the pharmacologic intervention and the smoking cessation therapy, and €17,200 for the pulmonary rehabilitation program. The probability of the interventions to be cost-effective at a ceiling ratio of €20,000 varied from 58% to 100%.

Conclusions

The COPD model provides policy makers with information about the long-term costs and effects of interventions over the entire chain of care, from primary prevention to care for very severe COPD and includes uncertainty around the outcomes.

Categories :
  • Cost-comparison, Effectiveness, Utility, Benefit Analysis
  • Decision Modeling & Simulation
  • Economic Evaluation
  • Respiratory-Related Disorders
  • Specific Diseases & Conditions
  • Study Approaches
Tags :
  • chronic obstructive pulmonary disease
  • exacerbations
  • model
  • probabilistic
  • progression
Regions :
  • Global
ViH Article Tags :