title: Assessing the determinants of the potential for cost-effectiveness over time: the empirical case of COPD.
abstract: OBJECTIVE
  The objective of this study was to assess the potential for cost-effectiveness of new technologies for chronic obstructive pulmonary disease (COPD) over the period from 2001 to 2010.
  
  
  METHODS
  Lung function outcomes and drug prices were observed for a UK COPD population over the period from 2001 to 2010. Cost-effectiveness was assessed at regular intervals on the basis of an established cost-effectiveness model, and the maximum price a technology providing cure could achieve under the current cost-effectiveness rules was estimated.
  
  
  RESULTS
  The results of this study show that although the scope for clinical improvement in COPD was still considerable, during the 10 years studied, the potential for cost-effectiveness at each point in time was dependent on momentary market characteristics, such as the changing price of comparators and improvements in clinical effectiveness. As a result, the analysis demonstrates that the future cost-effectiveness of a technology in development depends on the manner pricing and clinical effectiveness evolve throughout time.
  
  
  CONCLUSIONS
  Because any predictions will be short-lived and dependent on a number of uncertain factors, we conclude that producing accurate forecasts on the potential for cost-effectiveness of new therapies earlier during the development process is especially difficult under the current static cost-effectiveness framework.
authors.affiliation: Institute of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands. rodrigo.refoioscamejo@gmail.com
authors.forename: Rodrigo Refoios
authors.initials: RR
authors.lastname: Camejo
authors.forename: Clare
authors.initials: C
authors.lastname: McGrath
authors.forename: Ron
authors.initials: R
authors.lastname: Herings
authors.forename: Helen
authors.initials: H
authors.lastname: Starkie
authors.forename: Frans
authors.initials: F
authors.lastname: Rutten
mesh_terms: D000305:Adrenal Cortex Hormones / Q000191:economics / Q000627:therapeutic use; D000368:Aged; D001827:Body Height; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000145:classification / Q000191:economics / Q000627:therapeutic use; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D018450:Disease Progression; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects / Q000502:physiology; D006291:Health Policy / Q000191:economics*; D006801:Humans; D008297:Male; D009330:Nebulizers and Vaporizers / Q000191:economics; D029424:Pulmonary Disease, Chronic Obstructive / Q000191:economics* / Q000503:physiopathology / Q000628:therapy*; D019057:Quality-Adjusted Life Years; D013673:Technology Assessment, Biomedical / Q000191:economics*; D006113:United Kingdom
chemical_list: D000305:Adrenal Cortex Hormones; D001993:Bronchodilator Agents