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Böckmann, D. ; Szentes, B.L. ; Schultz, K.* ; Nowak, D.* ; Schuler, M.* ; Schwarzkopf, L.

Cost-effectiveness of pulmonary rehabilitation in patients with bronchial asthma: An analysis of the EPRA randomized controlled trial.

Value Health 24, 1254-1262 (2021)
Verlagsversion Postprint DOI PMC
Open Access Green
Objectives: At 3 months after the intervention, this study evaluates the cost-effectiveness of a 3-week inpatient pulmonary rehabilitation (PR) in patients with asthma compared with usual care alongside the single-center randomized controlled trial—Effectiveness of Pulmonary Rehabilitation in Patients With Asthma. Methods: Adopting a societal perspective, direct medical costs and productivity loss were assessed using the Questionnaire for Health-Related Resource Use-Lung, a modification of the FIM in an Elderly Population. The effect side was operationalized as minimal important differences (MIDs) of the Asthma Control Test (ACT) and the Asthma Quality of Life Questionnaire (AQLQ) and through quality-adjusted life-years (QALYs) gained. Adjusted mean differences in costs (gamma-distributed model) and each effect parameter (Gaussian-distributed model) were simultaneously calculated within 1000 bootstrap replications to determine incremental cost-effectiveness ratios (ICERs) and to subsequently delineate cost-effectiveness acceptability curves. Results: PR caused mean costs per capita of €3544. Three months after PR, we observed higher mean costs (Δ€3673; 95% confidence interval (CI) €2854-€4783) and improved mean effects (ACT Δ1.59 MIDs, 95% CI 1.37-1.81; AQLQ Δ1.76 MIDs, 95% CI 1.46-2.08; QALYs gained Δ0.01, 95% CI 0.01-0.02) in the intervention group. The ICER was €2278 (95% CI €1653-€3181) per ACT-MID, €1983 (95% CI €1430-€2830) per AQLQ-MID, and €312 401 (95% CI €209 206-€504 562) per QALY gained. Conclusions: Contrasting of PR expenditures with ICERs suggests that the intervention, which achieves clinically relevant changes in asthma-relevant parameters, has a high probability to be already cost-effective in the short term. However, in terms of QALYs, extended follow-up periods are likely required to comprehensively judge the added value of a one-time initial investment in PR.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Korrespondenzautor
Schlagwörter Asthma ; Asthma Control ; Health Economic Evaluation ; Health-related Quality Of Life ; Inpatient Rehabilitation; Quality-of-life; Respiratory Society Statement; Physiotherapy; Instruments; Validity; Outcomes; Program
ISSN (print) / ISBN 1098-3015
e-ISSN 1524-4733
Zeitschrift Value in Health
Quellenangaben Band: 24, Heft: 9, Seiten: 1254-1262 Artikelnummer: , Supplement: ,
Verlag Elsevier
Verlagsort New York, NY
Nichtpatentliteratur Publikationen
Begutachtungsstatus Peer reviewed
Institut(e) Institute of Health Economics and Health Care Management (IGM)
Förderungen Deutsche Rentenversicherung Bayern Sud (German Pension Insurance South Bavaria)