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基于技术的慢性阻塞性肺疾病身体活动方案具有成本效益吗?

Can Technology-Based Physical Activity Programs for Chronic Obstructive Pulmonary Disease Be Cost-Effective?

机构信息

Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, Massachusetts, USA.

Boston University School of Medicine, Boston, Massachusetts, USA.

出版信息

Telemed J E Health. 2021 Nov;27(11):1288-1292. doi: 10.1089/tmj.2020.0398. Epub 2021 Feb 24.

Abstract

To evaluate the cost-effectiveness of a technology-based physical activity (PA) intervention for chronic obstructive pulmonary disease (COPD). A secondary data analysis was performed from a randomized controlled trial in COPD of an activity monitor alone or an activity monitor plus a web-based PA intervention. Models estimated cost per quality-adjusted life year (QALY) and incremental cost-effectiveness ratios (ICERs) compared with usual care. The estimated ICER for both groups was below the willingness-to-pay threshold of $50,000/QALY (activity monitor alone = $10,437/QALY; website plus activity monitor intervention = $13,065/QALY). A probabilistic simulation estimated 76% of the activity monitor-alone group and 78% of the intervention group simulations to be cost-effective. Both the activity monitor-alone group and the activity monitor plus website group were cost-effective at the base case by using conventional willingness-to-pay thresholds. Further research would benefit from a more direct estimate of health utilities and downstream health care costs. Clinical Trials.gov NCT01102777.

摘要

评估基于技术的体力活动(PA)干预在慢性阻塞性肺疾病(COPD)中的成本效益。对 COPD 中活动监测仪单独或活动监测仪加基于网络的 PA 干预的随机对照试验进行了二次数据分析。模型估计了与常规护理相比的每质量调整生命年(QALY)的成本和增量成本效益比(ICER)。两组的估计 ICER 均低于 50,000 美元/QALY 的支付意愿阈值(活动监测仪单独组为 10,437 美元/QALY;网站加活动监测仪干预组为 13,065 美元/QALY)。概率模拟估计,活动监测仪单独组有 76%的模拟和干预组有 78%的模拟具有成本效益。在使用常规支付意愿阈值的情况下,活动监测仪单独组和活动监测仪加网站组在基本情况下均具有成本效益。进一步的研究将受益于对健康效用和下游医疗保健成本的更直接估计。临床试验.gov NCT01102777。

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