LAUSR

Background: Economic evaluation of non-pharmacological interventions in severe COPD patients is scarce. The COPD patient Management European Trial (COMET) compared a Disease Management (DM) intervention versus Usual Management (UM) in 4 countries: France, Italy, Germany and Spain. Objective: To perform an economic evaluation based upon the COMET study with the hypothesis that DM reduces mortality versus UM and is a cost-effective intervention in each country. Methods: Resource consumption collected from COMET trial and published tariffs were used to evaluate direct medical and non medical costs from the national payer perspective of each country. France, Germany and Spain with more than 50 included patients were analysed. Number of deaths avoided by DM was reported to cost differences vs. UM. Cost-effectiveness ratio was expressed in cost per death avoided. Probabilistic sensitivity analysis was performed to assess the probability (%) of being cost-effective (below 20,000€/death avoided acceptability threshold). Results: Cost-effectiveness results by country (DM-UM): Conclusion: Home-based DM should be considered as an interesting economic option for the management of severe COPD patients by national payers in Spain, Germany and France.