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Costs of COPD exacerbations in a general population. 普通人群COPD恶化的成本。

Ethics and Economics Pub Date : 2018-09-15 DOI: 10.1183/13993003.CONGRESS-2018.PA3157

M. Erdal, A. Johannessen, T. Eagan, P. Bakke, A. Gulsvik, J. Askildsen, Rune Grønseth

{"title":"Costs of COPD exacerbations in a general population.","authors":"M. Erdal, A. Johannessen, T. Eagan, P. Bakke, A. Gulsvik, J. Askildsen, Rune Grønseth","doi":"10.1183/13993003.CONGRESS-2018.PA3157","DOIUrl":"https://doi.org/10.1183/13993003.CONGRESS-2018.PA3157","url":null,"abstract":"Background: Studies on costs of COPD exacerbations from general populations are scarce. Objectives: To compare direct costs (treatment-related) and indirect costs (productivity-related) associated with COPD in population based and hospital-recruited samples, and to estimate the components related to moderate and severe exacerbations. Methods: We performed 4 telephone interviews with 81 COPD cases and 132 controls from a population-based survey and 205 hospital-recruited COPD-patients. A moderate exacerbation was defined by use of antibiotics or corticosteroids due to respiratory disease, and severe exacerbations by hospitalisation due to respiratory disease. The sum of direct and indirect costs gave the total costs. Initial analyses compared costs across the three groups, and multivariate quantile regression estimated the costs attributed to exacerbations. Results: The crude, annual mean total disease-related costs were €26518, €15021, and €6740 per person for the patients, cases, and controls (p Conclusion: The annual total health-related costs for a hospital-recruited COPD-patient were nearly twice that of a general population-based COPD-case. The most important cost driver was severe exacerbations.","PeriodicalId":243267,"journal":{"name":"Ethics and Economics","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129532438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Cost analysis of FeNO for asthma diagnosis in primary care in Germany. FeNO在德国初级保健中用于哮喘诊断的成本分析。

Ethics and Economics Pub Date : 2018-09-15 DOI: 10.1183/13993003.CONGRESS-2018.PA3151

Anna Dick, S. Wegner, Tanja Wollensak, C. Ernst

{"title":"Cost analysis of FeNO for asthma diagnosis in primary care in Germany.","authors":"Anna Dick, S. Wegner, Tanja Wollensak, C. Ernst","doi":"10.1183/13993003.CONGRESS-2018.PA3151","DOIUrl":"https://doi.org/10.1183/13993003.CONGRESS-2018.PA3151","url":null,"abstract":"Background: Measurement of the biomarker FeNO (fractionated exhaled nitric oxide) provides information on the degree of lung inflammation and can be used to support asthma diagnosis. The latest UK NICE asthma guideline (2017) recommends a diagnostic algorithm including FeNO, based on a cost-effectiveness analysis. In Germany FeNO testing is not yet reimbursed by the statutory health insurance (SHI) but endorsed in the national asthma guideline. Methods: To evaluate FeNO in primary care from SHI perspective, two diagnostic approaches were compared by modelling diagnostic accuracy and expected costs. The strategy according to the German guideline and the NICE diagnostic algorithm were transferred into decision trees. The probabilities used in the NICE cost-effectiveness analysis were inserted and supplemented by expert opinions on the underlying assumptions for Germany. Results: A base case was assumed for calculation of costs, in which 80% of the patients consult a general practitioner initially and 20% refer to a specialist. Further the case assumed a more frequent use of bronchial provocation instead of peak flow variability and a reimbursement of FeNO at 21.17 Euro per test. The resulting total sensitivity according to the German guideline is 78%, the total specificity 54% (PPV 53%, NPV 78%) and results in expected costs of 117.27 Euro. The UK NICE diagnosis algorithm transferred to Germany shows an overall sensitivity of 87%, specificity of 78% (PPV 73%, NPV 89%) and expected costs of 107.15 Euro. Conclusion: For the diagnosis of asthma, the strategy of the UK NICE guideline transferred to Germany is superior in terms of diagnostic accuracy and expected costs, up to a maximum price of 30 Euro per FeNO test.","PeriodicalId":243267,"journal":{"name":"Ethics and Economics","volume":"27 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129948468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Impact of once-daily single inhaler triple therapy on healthcare resource utilization and associated costs in COPD patients in Spain 西班牙COPD患者每日一次单一吸入器三联治疗对医疗资源利用及相关费用的影响

Ethics and Economics Pub Date : 2018-09-15 DOI: 10.1183/13993003.CONGRESS-2018.PA3155

L. Atienza, N. Benjamin, M. Schroeder, L. Vallejo-Aparicio, C. Biswas, D. Shah, A. Ismaila

引用次数: 4

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