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Cost-utility of a disease management program for patients with asthma

Published online by Cambridge University Press:  01 April 2007

Lotte Steuten ,
Stephen Palmer ,
Bert Vrijhoef ,
Frits van Merode ,
Cor Spreeuwenberg  and
Hans Severens
Lotte Steuten
Affiliation:
Maastricht University
Stephen Palmer
Affiliation:
University of York
Bert Vrijhoef
Affiliation:
Maastricht University and University Hospital Maastricht
Frits van Merode
Affiliation:
Maastricht University
Cor Spreeuwenberg
Affiliation:
Maastricht University and Institute for Rehabilitation Research
Hans Severens
Affiliation:
Maastricht University and University Hospital Maastricht
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Abstract

Objectives: The long-term cost-utility of a disease management program (DMP) for adults with asthma was assessed compared to usual care.

Methods: A DMP for patients with asthma has been developed and implemented in the region of Maastricht (The Netherlands). By integrating care, the program aims to continuously improve quality of care within existing budgets. A clinical trial was performed over a period of 15 months to collect data on costs and effects of the program and usual care. These data were used to inform a probabilistic decision-analytic model to estimate the 5-year impact of the program beyond follow-up. A societal perspective was adopted, with outcomes assessed in terms of costs per quality-adjusted life-year (QALY).

Results: The DMP is associated with a gain in QALYs compared to usual care (2.7±.2 versus 3.4±.8), at lower costs (€3,302±314 versus €2,973±304), thus leading to dominance. The probability that disease management is the more cost-effective strategy is 76 percent at a societal willingness to pay (WTP) for an additional QALY of €0, reaching 95 percent probability at a WTP of €1,000 per additional QALY.

Conclusions: Organizing health care according to the principles of disease management for adults with asthma has a high probability of being cost-effective and is associated with a gain in QALYs at lower costs.

Keywords

Disease managementEconomic evaluationDecision analysisAsthma
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 23 , Issue 2 , April 2007 , pp. 184 - 191
Copyright
Copyright © Cambridge University Press 2007

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