School of Health and Related Research, University of Sheffield, Sheffield, UK.
Manchester Centre for Health Economics, University of Manchester, Manchester, UK.
Int J Technol Assess Health Care. 2023 Jan 17;39(1):e6. doi: 10.1017/S0266462322003373.
Adherence to preventative inhaled therapies in people with cystic fibrosis (CF) is low, resulting in potentially avoidable health losses and the need for costly rescue therapies.
To estimate the cost-effectiveness of the CFHealthHub (CFHH) intervention to support adherence to inhaled medications.
A state transition model was developed to assess the cost-effectiveness of the CFHH intervention versus usual care from the perspective of the UK National Health Service and Personal Social Services over a lifetime horizon. Costs and health outcomes were discounted at a rate of 3.5 percent per annum. Costs were valued at 2021/22 prices. The model structure includes health states defined by survival status, level of lung function, and transplant history. Treatment effects were modeled by changing the probabilities of transitioning between lung function states and reducing exacerbation rates. Model parameters were informed by the CFHH trial, CF Registry data, routine cost databases, literature, and expert opinion. Deterministic and probabilistic sensitivity analyses were undertaken to assess uncertainty.
The CFHH intervention is expected to generate additional health gains and cost savings compared with usual care. Assuming that it is delivered for 10 years, the CFHH intervention is expected to generate 0.17 additional quality-adjusted life years and cost savings of GBP 1,600 (EUR 1,662) per patient.
The CFHH intervention is expected to dominate usual care, irrespective of the duration over which the intervention is delivered. The modeled benefits and cost savings are smaller than initially expected and are sensitive to relative treatment effects on lung function.
囊性纤维化（CF）患者预防吸入疗法的依从性较低，导致潜在可避免的健康损失和需要昂贵的抢救治疗。
评估 CFHealthHub（CFHH）干预措施对支持吸入药物依从性的成本效益。
开发了一个状态转移模型，从英国国家卫生服务和个人社会服务的角度评估 CFHH 干预与常规护理在终身范围内的成本效益。成本和健康结果以每年 3.5%的速度贴现。成本按 2021/22 年的价格计算。模型结构包括由生存状态、肺功能水平和移植史定义的健康状态。通过改变肺功能状态之间的转移概率和降低恶化率来模拟治疗效果。模型参数由 CFHH 试验、CF 登记处数据、常规成本数据库、文献和专家意见提供信息。进行了确定性和概率敏感性分析以评估不确定性。
与常规护理相比，CFHH 干预预计会带来额外的健康收益和成本节约。假设干预措施持续 10 年，CFHH 干预预计会增加 0.17 个额外的质量调整生命年，并为每位患者节省 1600 英镑（1662 欧元）的成本。
CFHH 干预预计将优于常规护理，无论干预措施的持续时间如何。建模的收益和成本节约小于最初预期，并且对肺功能的相对治疗效果敏感。
