Cost-utility analysis of a pharmacy-led self-management programme for patients with COPD

• DOI: 10.1007/s11096-011-9524-z
• Publication Date: 2011-06-03T15:23:46Z
• Authors: Maher R. Khdour; Ashley M. Agus; Joseph C. Kidney; Bronagh M. Smyth; James C. Elnay; Grainne E. Crealey
• Keywords: Male; name=Toxicology; name=Pharmacology; Pulmonary Disease, Chronic Obstructive; 03 medical and health sciences; 0302 clinical medicine; Patient Education as Topic; name=Pharmacy; /dk/atira/pure/subjectarea/asjc/3600/3611; Ambulatory Care; Humans; Aged; name=Pharmaceutical Science; /dk/atira/pure/subjectarea/asjc/3000/3004; /dk/atira/pure/subjectarea/asjc/3000/3005; 4. Education; Disease Management; Middle Aged; 3. Good health; Self Care; name=Pharmacology (medical); Treatment Outcome; /dk/atira/pure/subjectarea/asjc/2700/2736; Costs and Cost Analysis; Female; /dk/atira/pure/subjectarea/asjc/3000/3003; Follow-Up Studies

To undertake a cost-utility analysis (CUA) of a pharmacy-led self-management programme for Chronic Obstructive Pulmonary Disease (COPD).A single outpatient COPD clinic at the Mater Hospital, Belfast, Northern Ireland between.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 self-management 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.Cost per QALY gained.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 cost-effective 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.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.