PuSH - Publication Server of Helmholtz Zentrum München

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)
Publ. Version/Full Text 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.
Altmetric
Additional Metrics?
[➜Log in]
Edit extra informations Login
Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords 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
Journal Value in Health
Quellenangaben Volume: 24, Issue: 9, Pages: 1254-1262 Article Number: , Supplement: ,
Publisher Elsevier
Publishing Place New York, NY
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Health Economics and Health Care Management (IGM)
Grants Deutsche Rentenversicherung Bayern Sud (German Pension Insurance South Bavaria)