IDEAS home Printed from
MyIDEAS: Login to save this article or follow this journal

A Lifetime Markov Model for the Economic Evaluation of Chronic Obstructive Pulmonary Disease

  • Petra Menn

    (Institute of Health Economics and Health Care Management, Helmholtz Zentrum Munchen, Member of the German Center for Lung Research, Neuherberg, Germany)

  • Reiner Leidl

    (Institute of Health Economics and Health Care Management, Helmholtz Zentrum Munchen, Member of the German Center for Lung Research, Neuherberg, Germany)

  • Rolf Holle

    (Institute of Health Economics and Health Care Management, Helmholtz Zentrum Munchen, Member of the German Center for Lung Research, Neuherberg, Germany)

Background:Background: Chronic obstructive pulmonary disease (COPD) is currently the fourth leading cause of death worldwide. It has serious health effects and causes substantial costs for society. Abstract: Objectives:Objectives: The aim of the present paper was to develop a state-of-the-art decision-analytic model of COPD whereby the cost effectiveness of interventions in Germany can be estimated. To demonstrate the applicability of the model, a smoking cessation programme was evaluated against usual care. Abstract: Methods:Methods: A seven-stage Markov model (disease stages I to IV according to the GOLD [Global Initiative for Chronic Obstructive Lung Disease] classification, states after lung-volume reduction surgery and lung transplantation, death) was developed to conduct a cost-utility analysis from the societal perspective over a time horizon of 10, 40 and 60 years. Patients entered the cohort model at the age of 45 with mild COPD. Exacerbations were classified into three levels: mild, moderate and severe. Estimation of stage-specific probabilities (for smokers and quitters), utilities and costs was based on German data where possible. Data on effectiveness of the intervention was retrieved from the literature. A discount rate of 3% was applied to costs and effects. Probabilistic sensitivity analysis was used to assess the robustness of the results. Abstract: Results:Results: The smoking cessation programme was the dominant strategy compared with usual care, and the intervention resulted in an increase in health effects of 0.54 QALYs and a cost reduction of &U20AC;1115 per patient (year 2007 prices) after 60 years. In the probabilistic analysis, the intervention dominated in about 95% of the simulations. Sensitivity analyses showed that uncertainty primarily originated from data on disease progression and treatment cost in the early stages of disease. Abstract: Conclusions:Conclusions: The model developed allows the long-term cost effectiveness of interventions to be estimated, and has been adapted to Germany. The model suggests that the smoking cessation programme evaluated was more effective than usual care as well as being cost-saving. Most patients had mild or moderate COPD, stages for which parameter uncertainty was found to be high. This raises the need to improve data on the early stages of COPD.

If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.

File URL:
Download Restriction: Pay per view

File URL:
Download Restriction: Pay per view

As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.

Article provided by Springer Healthcare | Adis in its journal PharmacoEconomics.

Volume (Year): 30 (2012)
Issue (Month): 9 ()
Pages: 825-840

in new window

Handle: RePEc:wkh:phecon:v:30:y:2012:i:9:p:825-840
Contact details of provider: Web page:

References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:

as in new window
  1. Briggs, Andrew & Sculpher, Mark & Claxton, Karl, 2006. "Decision Modelling for Health Economic Evaluation," OUP Catalogue, Oxford University Press, number 9780198526629, May.
  2. O. Zaniolo & S. Iannazzo & L. Pradelli & M. Miravitlles, 2012. "Pharmacoeconomic evaluation of tiotropium bromide in the long-term treatment of chronic obstructive pulmonary disease (COPD) in Italy," The European Journal of Health Economics, Springer, vol. 13(1), pages 71-80, February.
  3. Petra Menn & Rolf Holle, 2009. "Comparing Three Software Tools for Implementing Markov Models for Health Economic Evaluations," PharmacoEconomics, Springer Healthcare | Adis, vol. 27(9), pages 745-753.
  4. Wolfgang Greiner & Tom Weijnen & Martin Nieuwenhuizen & Siem Oppe & Xavier Badia & Jan Busschbach & Martin Buxton & Paul Dolan & Paul Kind & Paul Krabbe & Arto Ohinmaa & David Parkin & Montserat Roset, 2003. "A single European currency for EQ-5D health states," The European Journal of Health Economics, Springer, vol. 4(3), pages 222-231, September.
  5. Zoe Philips & Laura Bojke & Mark Sculpher & Karl Claxton & Su Golder, 2006. "Good Practice Guidelines for Decision-Analytic Modelling in Health Technology Assessment: A Review and Consolidation of Quality Assessment," PharmacoEconomics, Springer Healthcare | Adis, vol. 24(4), pages 355-371.
  6. Maureen Rutten-van Mölken & Jan Oostenbrink & Marc Miravitlles & Brigitta Monz, 2007. "Modelling the 5-year cost effectiveness of tiotropium, salmeterol and ipratropium for the treatment of chronic obstructive pulmonary disease in Spain," The European Journal of Health Economics, Springer, vol. 8(2), pages 123-135, June.
Full references (including those not matched with items on IDEAS)

This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

When requesting a correction, please mention this item's handle: RePEc:wkh:phecon:v:30:y:2012:i:9:p:825-840. See general information about how to correct material in RePEc.

For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dave Dustin)

If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

If references are entirely missing, you can add them using this form.

If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.

If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.

Please note that corrections may take a couple of weeks to filter through the various RePEc services.

This information is provided to you by IDEAS at the Research Division of the Federal Reserve Bank of St. Louis using RePEc data.