title: Cost-utility analysis of a pharmacy-led self-management programme for patients with COPD.
abstract: OBJECTIVE
  To undertake a cost-utility analysis (CUA) of a pharmacy-led self-management programme for Chronic Obstructive Pulmonary Disease (COPD).
  
  
  METHODS
  A single outpatient COPD clinic at the Mater Hospital, Belfast, Northern Ireland between.
  
  
  METHODS
  CUA alongside a randomised control trial. The economic analysis used data from 127 COPD patients aged over 45 years, with an FEV1 of 30-80% of the predicted normal value. Participants received either a pharmacy-led education and self-management programme, or usual care. One year costs were estimated from the perspective of the National Health Service and Personal Social Services and quality-adjusted life years (QALYs) were calculated based on responses to the EQ-5D at baseline, 6 and 12 months.
  
  
  METHODS
  Cost per QALY gained.
  
  
  RESULTS
  The mean differences in costs and effects between the self-management and education programme and usual care were -£671.59 (95 CI%: -£1,584.73 to -£68.14) and 0.065 (95% CI; 0.000-0.128). Thus the intervention was the dominant strategy as it was both less costly and more effective than usual care. The probability of the intervention being cost-effective was 95% at a threshold of £20,000/QALY gained. Sensitivity analyses indicated that conclusions were robust to variations in most of the key parameters.
  
  
  CONCLUSIONS
  The self-management and education programme was found to be highly cost-effective compared to usual care. Further research is required to establish what aspects of self-management and education programmes have the greatest impact on cost-effectiveness.
authors.affiliation: Clinical and Practice Research Group, School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK.
authors.forename: Maher R
authors.initials: MR
authors.lastname: Khdour
authors.forename: Ashley M
authors.initials: AM
authors.lastname: Agus
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Kidney
authors.forename: Bronagh M
authors.initials: BM
authors.lastname: Smyth
authors.forename: James C
authors.initials: JC
authors.lastname: McElnay
authors.forename: James C
authors.initials: JC
authors.lastname: Elnay
authors.forename: Grainne E
authors.initials: GE
authors.lastname: Crealey
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000191:economics* / Q000379:methods; D003365:Costs and Cost Analysis; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000191:economics* / Q000379:methods; D029424:Pulmonary Disease, Chronic Obstructive / Q000191:economics* / Q000628:therapy*; D012648:Self Care / Q000191:economics* / Q000379:methods; D016896:Treatment Outcome