Open AccessSimulation-Based Estimates of the Effectiveness and Cost-Effectiveness of Pulmonary Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease in France
Author(s) -
Kokuvi Atsou,
Perrine Créquit,
C. Chouaïd,
Gilles Hejblum
Publication year - 2016
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0156514
Subject(s) - pulmonary rehabilitation , medicine , copd , life expectancy , cohort , quality adjusted life year , rehabilitation , pulmonary disease , cost effectiveness , physical therapy , intensive care medicine , population , risk analysis (engineering) , environmental health
Background The medico-economic impact of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD) is poorly documented. Objective To estimate the effectiveness and cost-effectiveness of pulmonary rehabilitation in a hypothetical cohort of COPD patients. Methods We used a multi-state Markov model, adopting society’s perspective. Simulated cohorts of French GOLD stage 2 to 4 COPD patients with and without pulmonary rehabilitation were compared in terms of life expectancy, quality-adjusted life years (QALY), disease-related costs, and the incremental cost-effectiveness ratio (ICER). Sensitivity analyses included variations of key model parameters. Principal Findings At the horizon of a COPD patient’s remaining lifetime, pulmonary rehabilitation would result in mean gain of 0.8 QALY, with an over disease-related costs of 14 102 € per patient. The ICER was 17 583 €/QALY. Sensitivity analysis showed that pulmonary rehabilitation was cost-effective in every scenario (ICER <50 000 €/QALY). Conclusions These results should provide a useful basis for COPD pulmonary rehabilitation programs.