Pub Date : 2018-09-15DOI: 10.1183/13993003.CONGRESS-2018.PA3162
D. Granados, J. Bourbeau, I. Durand-zaleski, S. Roze, R. Kessler
{"title":"Cost-utility analysis of a Home-based disease management intervention for patients with severe COPD in the COMET study.","authors":"D. Granados, J. Bourbeau, I. Durand-zaleski, S. Roze, R. Kessler","doi":"10.1183/13993003.CONGRESS-2018.PA3162","DOIUrl":"https://doi.org/10.1183/13993003.CONGRESS-2018.PA3162","url":null,"abstract":"","PeriodicalId":243267,"journal":{"name":"Ethics and Economics","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132170833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-15DOI: 10.1183/13993003.CONGRESS-2018.PA3166
Ç. Tezel, Onur Derdiyok, S. Evman, Serda Kanbur, M. Demir, L. Alpay, V. Baysungur
{"title":"Prospective study of last minute cancellations of thoracic surgery operations and preventive measures","authors":"Ç. Tezel, Onur Derdiyok, S. Evman, Serda Kanbur, M. Demir, L. Alpay, V. Baysungur","doi":"10.1183/13993003.CONGRESS-2018.PA3166","DOIUrl":"https://doi.org/10.1183/13993003.CONGRESS-2018.PA3166","url":null,"abstract":"","PeriodicalId":243267,"journal":{"name":"Ethics and Economics","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123722412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-15DOI: 10.1183/13993003.CONGRESS-2018.PA3154
Alan A Martin, D. Shah, E. Goodall, M. Schroeder, N. Risebrough, K. Ndirangu, A. Ismaila
Background: IMPACT (InforMing the PAthway of COPD Treatment, NCT02164513), showed superior exacerbation reduction and lung function improvement with single inhaler, once-daily fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) 100/62.5/22μg vs once-daily FF/VI 100/22μg, for patients with moderate/severe COPD. Objectives: The cost-effectiveness of FF/UMEC/VI vs FF/VI was assessed, from a Canadian public payer perspective. Methods: A validated linked risk equation model (Briggs, Med Decis Making 37;4 2017), which predicts COPD disease progression, associated healthcare costs and health outcomes, was populated with baseline characteristics, efficacy and medication use from IMPACT. Canadian healthcare resource unit costs and drug costs were applied, with future costs and health outcomes discounted at 1.5% annually. Analysis was probabilistic, with a lifetime horizon and outputs including exacerbation rates, costs (2017 CAD), quality-adjusted life years (QALYs) gained and incremental cost effectiveness ratio (ICER) per QALY. Results: Compared with FF/VI, FF/UMEC/VI treatment resulted in fewer moderate and severe exacerbations (10.52 and 3.38 vs 11.13 and 3.48), mean (95% CI) incremental costs and QALYs of $2,598 ($2,010, $3,268) and 0.13 (0.09, 0.18), and an ICER of $19,649 per QALY ($15,406, $26,454). The probability of FF/UMEC/VI being cost-effective vs FF/VI was 100% at a willingness-to-pay threshold of $50,000 per QALY. Results were most sensitive to time horizon, and efficacy of treatment post-discontinuation. Conclusions: FF/UMEC/VI was predicted to improve health outcomes and to be a cost-effective option for treatment of moderate/severe COPD compared with FF/VI, in Canada.
背景:IMPACT(通知慢性阻塞性肺病治疗途径，NCT02164513)显示，对于中/重度慢性阻塞性肺病患者，每日一次氟替卡松/乌莫替尼/维兰特罗(FF/UMEC/VI) 100/62.5/22μg与每日一次FF/VI 100/22μg相比，使用单一吸入器可显著减少急性加重和改善肺功能。目的:从加拿大公共支付者的角度评估FF/UMEC/VI与FF/VI的成本效益。方法:一个经过验证的关联风险方程模型(Briggs, Med Decis Making 37;4 2017)，预测COPD疾病进展、相关医疗成本和健康结果，并填充IMPACT的基线特征、疗效和药物使用。采用加拿大医疗资源单位成本和药品成本，未来成本和健康结果每年折现1.5%。分析是概率性的，其生命周期和输出包括恶化率、成本(2017年CAD)、获得的质量调整生命年(QALYs)和每个QALY的增量成本效益比(ICER)。结果:与FF/VI相比，FF/UMEC/VI治疗导致的中度和重度恶化较少(10.52和3.38 vs 11.13和3.48)，平均(95% CI)增量成本和QALY分别为2,598美元(2,010美元，3,268美元)和0.13美元(0.09,0.18)，ICER为每个QALY 19,649美元(15,406美元，26,454美元)。FF/UMEC/VI与FF/VI相比具有成本效益的可能性为100%，每个QALY的支付意愿阈值为50,000美元。结果对停药后治疗的时间范围和疗效最为敏感。结论:在加拿大，与FF/VI相比，FF/UMEC/VI预计可以改善健康结果，并且是治疗中/重度COPD的一种具有成本效益的选择。
{"title":"Cost-effectiveness of a single inhaler triple therapy versus ICS/LABA in COPD","authors":"Alan A Martin, D. Shah, E. Goodall, M. Schroeder, N. Risebrough, K. Ndirangu, A. Ismaila","doi":"10.1183/13993003.CONGRESS-2018.PA3154","DOIUrl":"https://doi.org/10.1183/13993003.CONGRESS-2018.PA3154","url":null,"abstract":"Background: IMPACT (InforMing the PAthway of COPD Treatment, NCT02164513), showed superior exacerbation reduction and lung function improvement with single inhaler, once-daily fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) 100/62.5/22μg vs once-daily FF/VI 100/22μg, for patients with moderate/severe COPD. Objectives: The cost-effectiveness of FF/UMEC/VI vs FF/VI was assessed, from a Canadian public payer perspective. Methods: A validated linked risk equation model (Briggs, Med Decis Making 37;4 2017), which predicts COPD disease progression, associated healthcare costs and health outcomes, was populated with baseline characteristics, efficacy and medication use from IMPACT. Canadian healthcare resource unit costs and drug costs were applied, with future costs and health outcomes discounted at 1.5% annually. Analysis was probabilistic, with a lifetime horizon and outputs including exacerbation rates, costs (2017 CAD), quality-adjusted life years (QALYs) gained and incremental cost effectiveness ratio (ICER) per QALY. Results: Compared with FF/VI, FF/UMEC/VI treatment resulted in fewer moderate and severe exacerbations (10.52 and 3.38 vs 11.13 and 3.48), mean (95% CI) incremental costs and QALYs of $2,598 ($2,010, $3,268) and 0.13 (0.09, 0.18), and an ICER of $19,649 per QALY ($15,406, $26,454). The probability of FF/UMEC/VI being cost-effective vs FF/VI was 100% at a willingness-to-pay threshold of $50,000 per QALY. Results were most sensitive to time horizon, and efficacy of treatment post-discontinuation. Conclusions: FF/UMEC/VI was predicted to improve health outcomes and to be a cost-effective option for treatment of moderate/severe COPD compared with FF/VI, in Canada.","PeriodicalId":243267,"journal":{"name":"Ethics and Economics","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130821562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-15DOI: 10.1183/13993003.CONGRESS-2018.PA3165
Herminia Ortiz Mayoral, R. López, R. M. Íñiguez, N. Santamaría, María Teresa Río Ramírez, I. A. García, B. Steen, Mercedes Izquierdo Patrón, Beatriz Morales Chacón
{"title":"Quality indicators in pleural pathology","authors":"Herminia Ortiz Mayoral, R. López, R. M. Íñiguez, N. Santamaría, María Teresa Río Ramírez, I. A. García, B. Steen, Mercedes Izquierdo Patrón, Beatriz Morales Chacón","doi":"10.1183/13993003.CONGRESS-2018.PA3165","DOIUrl":"https://doi.org/10.1183/13993003.CONGRESS-2018.PA3165","url":null,"abstract":"","PeriodicalId":243267,"journal":{"name":"Ethics and Economics","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115449126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-15DOI: 10.1183/13993003.CONGRESS-2018.PA3152
D. Byng, J. Lutter, R. Holle, R. Jörres, A. Karch, S. Karrasch, H. Schulz, C. Vogelmeier, M. Wacker
Background: COPD is associated with excess healthcare utilization and represents high costs to health systems. This study reports trends in healthcare utilization and healthcare costs and identifies predictors of cost changes. Methods: 1904 COPD patients participated in the baseline and 18 months follow-up visit of the German COSYCONET cohort study. Costs were calculated from a societal perspective. Predictors of changes in direct costs at the follow up visit were identified by gamma regression models using baseline information on GOLD grade, age, sex, education, BMI, smoking status, comorbidity count, years since COPD diagnosis, symptoms, and exacerbation history. Adjusted mean direct costs at baseline and follow-up were obtained through generalized estimating equation model. Results: Inflation adjusted mean annual direct costs increased by 5 % (non-significant). Besides direct costs at baseline, higher baseline COPD grades, a history of severe exacerbations in the previous 12 months and comorbidity count >3 were significantly associated with higher total direct costs at the follow-up visit. No statistically significant effects were found for smoking status, years since COPD diagnosis and symptoms (with the exception of dyspnea). Adjusted mean direct costs increased between baseline and follow-up (except in the case of GOLD grade 4). Nevertheless, selective drop out may have led to an underestimation of cost increase. Conclusions: Our findings underline the importance of managing symptoms, exacerbations and comorbidities in the treatment of COPD patients to control the development of direct healthcare costs of COPD over time.
{"title":"Identifying predictors of healthcare utilization and costs in COPD patients over 18 months: first longitudinal results of the COSYCONET cohort","authors":"D. Byng, J. Lutter, R. Holle, R. Jörres, A. Karch, S. Karrasch, H. Schulz, C. Vogelmeier, M. Wacker","doi":"10.1183/13993003.CONGRESS-2018.PA3152","DOIUrl":"https://doi.org/10.1183/13993003.CONGRESS-2018.PA3152","url":null,"abstract":"Background: COPD is associated with excess healthcare utilization and represents high costs to health systems. This study reports trends in healthcare utilization and healthcare costs and identifies predictors of cost changes. Methods: 1904 COPD patients participated in the baseline and 18 months follow-up visit of the German COSYCONET cohort study. Costs were calculated from a societal perspective. Predictors of changes in direct costs at the follow up visit were identified by gamma regression models using baseline information on GOLD grade, age, sex, education, BMI, smoking status, comorbidity count, years since COPD diagnosis, symptoms, and exacerbation history. Adjusted mean direct costs at baseline and follow-up were obtained through generalized estimating equation model. Results: Inflation adjusted mean annual direct costs increased by 5 % (non-significant). Besides direct costs at baseline, higher baseline COPD grades, a history of severe exacerbations in the previous 12 months and comorbidity count >3 were significantly associated with higher total direct costs at the follow-up visit. No statistically significant effects were found for smoking status, years since COPD diagnosis and symptoms (with the exception of dyspnea). Adjusted mean direct costs increased between baseline and follow-up (except in the case of GOLD grade 4). Nevertheless, selective drop out may have led to an underestimation of cost increase. Conclusions: Our findings underline the importance of managing symptoms, exacerbations and comorbidities in the treatment of COPD patients to control the development of direct healthcare costs of COPD over time.","PeriodicalId":243267,"journal":{"name":"Ethics and Economics","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125776942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-15DOI: 10.1183/13993003.CONGRESS-2018.PA3164
Birsen Ocaklı, A. Yorgancioglu, F. Topcu, N. Kokturk, H. Altınöz, Y. Yasin, İlknur Genc Kuzuca, Serap Duru, Elif Yildirim, T. Sevim, Serpil Tekgul, E. Tunçay, S. Gungor, B. Goktas, Y. Şenol, Can Ozturk, I. Ozmen, C. Taştan, S. Dülger, E. Uzaslan, F. Erboy, E. Aksoy, P. Gulhan, A. Koçabas, B. Gemicioğlu, S. Topçu, G. Altinisik, P. Çelik
{"title":"Determination of Attitudes of Turkish Thoracic Society Members on Exposure to Sexist Approach and Sexism in Business Life","authors":"Birsen Ocaklı, A. Yorgancioglu, F. Topcu, N. Kokturk, H. Altınöz, Y. Yasin, İlknur Genc Kuzuca, Serap Duru, Elif Yildirim, T. Sevim, Serpil Tekgul, E. Tunçay, S. Gungor, B. Goktas, Y. Şenol, Can Ozturk, I. Ozmen, C. Taştan, S. Dülger, E. Uzaslan, F. Erboy, E. Aksoy, P. Gulhan, A. Koçabas, B. Gemicioğlu, S. Topçu, G. Altinisik, P. Çelik","doi":"10.1183/13993003.CONGRESS-2018.PA3164","DOIUrl":"https://doi.org/10.1183/13993003.CONGRESS-2018.PA3164","url":null,"abstract":"","PeriodicalId":243267,"journal":{"name":"Ethics and Economics","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124297577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-15DOI: 10.1183/13993003.CONGRESS-2018.PA3167
Biljana Ilievska Poposka, M. Zakoska
{"title":"Training on the Practical approach to Lung Health- 3 years experience in the Republic of Macedonia","authors":"Biljana Ilievska Poposka, M. Zakoska","doi":"10.1183/13993003.CONGRESS-2018.PA3167","DOIUrl":"https://doi.org/10.1183/13993003.CONGRESS-2018.PA3167","url":null,"abstract":"","PeriodicalId":243267,"journal":{"name":"Ethics and Economics","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122750407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-15DOI: 10.1183/13993003.CONGRESS-2018.PA3163
R. Dobra, T. Higgins, K. Huband, E. Guilmant, S. Fleming
{"title":"Patient views on payment for trial participation","authors":"R. Dobra, T. Higgins, K. Huband, E. Guilmant, S. Fleming","doi":"10.1183/13993003.CONGRESS-2018.PA3163","DOIUrl":"https://doi.org/10.1183/13993003.CONGRESS-2018.PA3163","url":null,"abstract":"","PeriodicalId":243267,"journal":{"name":"Ethics and Economics","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116747391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-15DOI: 10.1183/13993003.CONGRESS-2018.PA3156
C. Chouaid, N. Germain, G. Pouvourville, S. Aballéa, D. Korchagina, M. Baldwin, K. Lay, L. Luciani, P. Devillier
Introduction: Poor inhaler adherence is a major challenge in chronic obstructive pulmonary disease (COPD), and understanding drivers of inhaler preferences may contribute to adherence and improve long term outcomes. Aims and objective: To identify and quantify preferences for inhaler attributes in French COPD patients, by using DCE methodology. Methods: Attributes were defined from a literature search, expert and patient interviews. An online DCE with COPD patients aged 40-75, using an inhaler for COPD was conducted. The pilot study included scenarios of two fictitious inhalers described according to the attributes. The COPD Assessment Test and 18 questions on diagnosis, treatment and socio-demographic profile were included. A D-efficient design with zero priors was used. Analyses used a conditional logit model with interactions. Results: Seven inhaler attributes were defined: shape, dose insertion, dose preparation, dose release, dose confirmation, dose counter, and reusability. Twenty-one patients completed the pilot phase, and 5 did cognitive debriefing interviews. The mean CAT score was 27.14 (range 17-40). Results show the most valued characteristics to be dose insertion, dose counter and reusability, with a tendency to prefer fewer dose preparation steps, and reusable inhalers with a dose counter. Conclusion: The pilot results suggest that the selected attributes are relevant to COPD patients in France, and should therefore be taken into account by healthcare professionals considering treatment options. In the full online survey, 150 patients with COPD will be included; will confirm which attributes are most valued for French COPD patients.
{"title":"Patient preference for COPD treatment inhalers: A Discrete Choice Experiment (DCE) in France – Results of a Pilot Study","authors":"C. Chouaid, N. Germain, G. Pouvourville, S. Aballéa, D. Korchagina, M. Baldwin, K. Lay, L. Luciani, P. Devillier","doi":"10.1183/13993003.CONGRESS-2018.PA3156","DOIUrl":"https://doi.org/10.1183/13993003.CONGRESS-2018.PA3156","url":null,"abstract":"Introduction: Poor inhaler adherence is a major challenge in chronic obstructive pulmonary disease (COPD), and understanding drivers of inhaler preferences may contribute to adherence and improve long term outcomes. Aims and objective: To identify and quantify preferences for inhaler attributes in French COPD patients, by using DCE methodology. Methods: Attributes were defined from a literature search, expert and patient interviews. An online DCE with COPD patients aged 40-75, using an inhaler for COPD was conducted. The pilot study included scenarios of two fictitious inhalers described according to the attributes. The COPD Assessment Test and 18 questions on diagnosis, treatment and socio-demographic profile were included. A D-efficient design with zero priors was used. Analyses used a conditional logit model with interactions. Results: Seven inhaler attributes were defined: shape, dose insertion, dose preparation, dose release, dose confirmation, dose counter, and reusability. Twenty-one patients completed the pilot phase, and 5 did cognitive debriefing interviews. The mean CAT score was 27.14 (range 17-40). Results show the most valued characteristics to be dose insertion, dose counter and reusability, with a tendency to prefer fewer dose preparation steps, and reusable inhalers with a dose counter. Conclusion: The pilot results suggest that the selected attributes are relevant to COPD patients in France, and should therefore be taken into account by healthcare professionals considering treatment options. In the full online survey, 150 patients with COPD will be included; will confirm which attributes are most valued for French COPD patients.","PeriodicalId":243267,"journal":{"name":"Ethics and Economics","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128331575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-15DOI: 10.1183/13993003.CONGRESS-2018.PA3161
S. Razzaq, Aysha Zahidie, Z. Fatmi
{"title":"Household expenditure for tuberculosis care, its determinants and coping strategies among adults 18 years and older of Karachi, Pakistan.","authors":"S. Razzaq, Aysha Zahidie, Z. Fatmi","doi":"10.1183/13993003.CONGRESS-2018.PA3161","DOIUrl":"https://doi.org/10.1183/13993003.CONGRESS-2018.PA3161","url":null,"abstract":"","PeriodicalId":243267,"journal":{"name":"Ethics and Economics","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132691237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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