Cost-utility analysis of a pharmacy-led self-management programme for patients with COPD
Date
2011-06-04
Authors
Khdour, Maher R.
Agus, Ashley M.
Kidney, Joseph C.
Smyth, Bronagh M.
Elnay, James C.
Crealey, Grainne E.
Journal Title
Journal ISSN
Volume Title
Publisher
Springer Science+Business Media B.V. 2011
Abstract
Objective: To undertake a cost-utility analysis
(CUA) of a pharmacy-led self-management programme for
Chronic Obstructive Pulmonary Disease (COPD). Setting:
A single outpatient COPD clinic at the Mater Hospital,
Belfast, Northern Ireland between. Method: CUA alongside
a randomised control trial. The economic analysis used
data from 127 COPD patients aged over 45 years, with an
FEV1 of 30–80% of the predicted normal value. Participants
received either a pharmacy-led education and selfmanagement
programme, or usual care. One year costs
were estimated from the perspective of the National Health
Service and Personal Social Services and quality-adjusted
life years (QALYs) were calculated based on responses to
the EQ-5D at baseline, 6 and 12 months. Main outcome
measure: Cost per QALY gained. Results: The mean differences
in costs and effects between the self-management
and education programme and usual care were -£671.59
(95 CI%: -£1,584.73 to -£68.14) and 0.065 (95% CI;
0.000–0.128). Thus the intervention was the dominant
strategy as it was both less costly and more effective than
usual care. The probability of the intervention being costeffective
was 95% at a threshold of £20,000/QALY gained. Sensitivity analyses indicated that conclusions were robust
to variations in most of the key parameters. Conclusion:
The self-management and education programme was found
to be highly cost-effective compared to usual care. Further
research is required to establish what aspects of self-management
and education programmes have the greatest
impact on cost-effectiveness.
Description
Keywords
COPD , Cost-effectiveness analysis , Costutility analysis , Education , RCT , Self-management , United Kingdom