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Cost Effectiveness of Case Detection Strategies for the Early Detection of COPD


  • Kate M. Johnson

    (University of British Columbia
    University of Washington)

  • Mohsen Sadatsafavi

    (University of British Columbia
    Vancouver Coastal Health Institute
    University of British Columbia)

  • Amin Adibi

    (University of British Columbia)

  • Larry Lynd

    (University of British Columbia
    Providence Health Research Institute)

  • Mark Harrison

    (University of British Columbia
    Providence Health Research Institute)

  • Hamid Tavakoli

    (University of British Columbia)

  • Don D. Sin

    (St. Paul’s Hospital)

  • Stirling Bryan

    (Vancouver Coastal Health Institute
    University of British Columbia)


Objectives The value of early detection and treatment of chronic obstructive pulmonary disease (COPD) is currently unknown. We assessed the cost effectiveness of primary care-based case detection strategies for COPD. Methods A previously validated discrete event simulation model of the general population of COPD patients in Canada was used to assess the cost effectiveness of 16 case detection strategies. In these strategies, eligible patients (based on age, smoking history, or symptoms) received the COPD Diagnostic Questionnaire (CDQ) or screening spirometry, at 3- or 5-year intervals, during routine visits to a primary care physician. Newly diagnosed patients received treatment for smoking cessation and guideline-based inhaler pharmacotherapy. Analyses were conducted over a 20-year time horizon from the healthcare payer perspective. Costs are in 2019 Canadian dollars ($). Key treatment parameters were varied in one-way sensitivity analysis. Results Compared to no case detection, all 16 case detection scenarios had an incremental cost-effectiveness ratio (ICER) below $50,000/QALY gained. In the most efficient scenario, all patients aged ≥ 40 years received the CDQ at 3-year intervals. This scenario was associated with an incremental cost of $287 and incremental effectiveness of 0.015 QALYs per eligible patient over the 20-year time horizon, resulting in an ICER of $19,632/QALY compared to no case detection. Results were most sensitive to the impact of treatment on the symptoms of newly diagnosed patients. Conclusions Primary care-based case detection programs for COPD are likely to be cost effective if there is adherence to best-practice recommendations for treatment, which can alleviate symptoms in newly diagnosed patients.

Suggested Citation

  • Kate M. Johnson & Mohsen Sadatsafavi & Amin Adibi & Larry Lynd & Mark Harrison & Hamid Tavakoli & Don D. Sin & Stirling Bryan, 2021. "Cost Effectiveness of Case Detection Strategies for the Early Detection of COPD," Applied Health Economics and Health Policy, Springer, vol. 19(2), pages 203-215, March.
  • Handle: RePEc:spr:aphecp:v:19:y:2021:i:2:d:10.1007_s40258-020-00616-2
    DOI: 10.1007/s40258-020-00616-2

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    As found by, the blog aggregator for Economics research:
    1. Journal round-up: Applied Health Economics and Health Policy 19(2)
      by karanshahk2 in The Academic Health Economists' Blog on 2021-04-19 06:00:07

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