Cost-utility analysis of a pharmacy-led self-management programme for patients with COPD
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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 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. 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 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. 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.
KeywordsCOPD Cost-effectiveness analysis Cost-utility analysis Education RCT Self-management United Kingdom
We are very grateful for the advice and feedback provided by the anonymous reviewers of this paper during its revision.
The authors wish to thank Chest Heart and Stroke (Northern Ireland) for financial support.
Conflicts of interests
None to declare.
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