Economic Evaluation of Community-Based Case Management of Patients Suffering From Chronic Obstructive Pulmonary Disease

Sabrina Storgaard Sørensen (), Kjeld Møller Pedersen (), Ulla Møller Weinreich () and Lars Ehlers ()
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Sabrina Storgaard Sørensen: Aalborg University
Kjeld Møller Pedersen: Aalborg University
Ulla Møller Weinreich: Aalborg University Hospital
Lars Ehlers: Aalborg University

Applied Health Economics and Health Policy, 2017, vol. 15, issue 3, No 12, 413-424

Abstract: Abstract Objectives To analyse the cost effectiveness of community-based case management for patients suffering from chronic obstructive pulmonary disease (COPD). Methods The study took place in the third largest municipality in Denmark and was conducted as a randomised controlled trial with 12 months of follow-up. A total of 150 patients with COPD were randomised into two groups receiving usual care and case management in addition to usual care. Case management included among other things self care proficiency, medicine compliance, and care coordination. Outcome measure for the analysis was the incremental cost-effectiveness ratio (ICER) as cost per quality-adjusted life year (QALY) from the perspective of the healthcare sector. Costs were valued in British Pounds (£) at price level 2016. Scenario analyses and probabilistic sensitivity analyses were conducted in order to assess uncertainty of the ICER estimate. Results The intervention resulted in a QALY improvement of 0.0146 (95% CI −0.0216; 0.0585), and a cost increase of £494 (95% CI −1778; 2766) per patient. No statistically significant difference was observed either in costs or effects. The ICER was £33,865 per QALY gained. Scenario analyses confirmed the robustness of the result and revealed slightly lower ICERs of £28,100–£31,340 per QALY. Conclusions Analysis revealed that case management led to a positive incremental QALY, but were more costly than usual care. The highly uncertain ICER somewhat exceeds for instance the threshold value used by the National Institute of Health and Care Excellence (NICE). No formally established Danish threshold value exists. ClinicalTrials.gov Identifier: NCT01512836.

Keywords: Chronic Obstructive Pulmonary Disease; Usual Care; Case Management; Chronic Obstructive Pulmonary Disease Patient; Scenario Analysis (search for similar items in EconPapers)
Date: 2017
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DOI: 10.1007/s40258-016-0298-2

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