Comparative cost-effectiveness analysis of theophylline and ipratropium bromide in chronic obstructive pulmonary disease. A three-center study.
The charts of 311 patients receiving theophylline (T) and 289 patients receiving ipratropium bromide (IB) for COPD were reviewed to determine the total costs and cost-effectiveness of these 2 agents in 3 different health-care settings. A direct cost-accounting method assessed cost, and a Markov decision-analysis model calculated cost-effectiveness. Costs to treat toxic effects were greater for T versus IB. The types and incidences of toxic effects, by drug, were similar among the three centers. Overall costs for T were $121.40 per patient per therapy-month versus $84.56 per patient per therapy-month for IB, as determined by the cost-accounting method. The marginal cost was $366 for T over IB when extrapolated over 1 year using the Markov model. The Markov model also predicted that patients receiving IB had a greater number of complication-free therapy-months (measurement of effectiveness) than patients receiving T. We conclude that treatment with IB was less costly and more cost-effective than T.
Jubran
A
A
Division of Pulmonary and Critical Care Medicine, Edward Hines Jr. Veterans Administration Hospital, Hines, IL.
Gross
N
N
Ramsdell
J
J
Simonian
R
R
Schuttenhelm
K
K
Sax
M
M
Kaniecki
D J
DJ
Arnold
R J
RJ
Sonnenberg
F A
FA
D000368:Aged; D000704:Analysis of Variance; D002140:California; D016009:Chi-Square Distribution; D017281:Cost of Illness; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data*; D005260:Female; D006279:Health Maintenance Organizations / Q000191:economics / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000191:economics / Q000706:statistics & numerical data; D006787:Hospitals, Veterans / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007087:Illinois; D009241:Ipratropium / Q000009:adverse effects / Q000191:economics*; D008173:Lung Diseases, Obstructive / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013806:Theophylline / Q000009:adverse effects / Q000191:economics*; D016896:Treatment Outcome
D013806:Theophylline; D009241:Ipratropium