Cost-effectiveness analysis of COPD screening programs in primary care for high-risk patients in China

Liwen Fang,Tianyi Liu,Mao Huang,Jinping Zheng,Lijiao Wang,Chong Ye,Hongchao Li,Yanjun Liu,Ting Yang,Zheng Yin,Shuli Qu,Xuedan You

doi:10.1038/s41533-021-00233-z

Abstract

We built a decision-analytic model to compare the cost-effectiveness of using portable spirometer and questionnaire to screen chronic obstructive pulmonary diseases (COPD) with no screening (i.e. usual care) among chronic bronchitis patient in China. A lifetime horizon and a payer perspective were adopted. Cost data of health services including spirometry screening and treatment costs covered both maintenance and exacerbation. The result indicated that portable spirometer screening was cost-saving compared with questionnaire screening and no screening, with an incremental cost-effectiveness ratio (ICER) of −5026 and −1766 per QALY, respectively. Sensitivity analyses confirmed the robustness of the results. In summary, portable spirometer screening is likely the optimal option for COPD screening among chronic bronchitis patients China.

Highlights

Chronic obstructive pulmonary disease (COPD) refers to a progressive deterioration of lung function which may cause a series of mental and physical comorbidities
Portable spirometer screening was cost-saving compared with questionnaire screening and no screening, with the incremental quality-adjusted life-years (QALYs) of 0.05 and 0.37, and cost saving of ¥229 and ¥647, respectively
Portable spirometer is the optimal option for COPD screening among Chronic bronchitis (CB) patients in China, and questionnaire is cost-saving option compared with no screening

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) refers to a progressive deterioration of lung function which may cause a series of mental and physical comorbidities. The nation-wide study of COPD in China reported a prevalence of 8.2% among people aged over 40 in 2002–20042. Based on a study examining the disease-specific funding level and disease burden of China, compared with other leading causes of death such as ischemic heart disease, stroke, and diabetes, COPD received the least funding[5]. People with early diagnosis have the chance to receive the COPD treatment earlier. COPD patients frequently remain undiagnosed and untreated when the disease is in its mild forms[7]. A nationwide observational study in China reported that half of COPD patients were diagnosed when the disease was already in moderate-to-severe stage[4]

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