title: Comparative cost-effectiveness analysis of theophylline and ipratropium bromide in chronic obstructive pulmonary disease. A three-center study.
abstract: 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.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Edward Hines Jr. Veterans Administration Hospital, Hines, IL.
authors.forename: A
authors.initials: A
authors.lastname: Jubran
authors.forename: N
authors.initials: N
authors.lastname: Gross
authors.forename: J
authors.initials: J
authors.lastname: Ramsdell
authors.forename: R
authors.initials: R
authors.lastname: Simonian
authors.forename: K
authors.initials: K
authors.lastname: Schuttenhelm
authors.forename: M
authors.initials: M
authors.lastname: Sax
authors.forename: D J
authors.initials: DJ
authors.lastname: Kaniecki
authors.forename: R J
authors.initials: RJ
authors.lastname: Arnold
authors.forename: F A
authors.initials: FA
authors.lastname: Sonnenberg
mesh_terms: 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
chemical_list: D013806:Theophylline; D009241:Ipratropium