title: Economic Evaluation of Community-Based Case Management of Patients Suffering From Chronic Obstructive Pulmonary Disease.
abstract: OBJECTIVE
  To analyse the cost effectiveness of community-based case management for patients suffering from chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  The study took place in the third largest municipality in Denmark and was conducted as a randomised controlled trial with 12 months of follow-up. A total of 150 patients with COPD were randomised into two groups receiving usual care and case management in addition to usual care. Case management included among other things self care proficiency, medicine compliance, and care coordination. Outcome measure for the analysis was the incremental cost-effectiveness ratio (ICER) as cost per quality-adjusted life year (QALY) from the perspective of the healthcare sector. Costs were valued in British Pounds (£) at price level 2016. Scenario analyses and probabilistic sensitivity analyses were conducted in order to assess uncertainty of the ICER estimate.
  
  
  RESULTS
  The intervention resulted in a QALY improvement of 0.0146 (95% CI -0.0216; 0.0585), and a cost increase of £494 (95% CI -1778; 2766) per patient. No statistically significant difference was observed either in costs or effects. The ICER was £33,865 per QALY gained. Scenario analyses confirmed the robustness of the result and revealed slightly lower ICERs of £28,100-£31,340 per QALY.
  
  
  CONCLUSIONS
  Analysis revealed that case management led to a positive incremental QALY, but were more costly than usual care. The highly uncertain ICER somewhat exceeds for instance the threshold value used by the National Institute of Health and Care Excellence (NICE). No formally established Danish threshold value exists. ClinicalTrials.gov Identifier: NCT01512836.
authors.affiliation: Department of Business and Management, Danish Center for Healthcare Improvements, Aalborg University, Fibigerstræde 11, 9220, Aalborg, Denmark. sabrinastorgaardsoerensen@gmail.com.
authors.forename: Sabrina Storgaard
authors.initials: SS
authors.lastname: Sørensen
authors.affiliation: Department of Business and Management, Danish Center for Healthcare Improvements, Aalborg University, Fibigerstræde 11, 9220, Aalborg, Denmark.|University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
authors.forename: Kjeld Møller
authors.initials: KM
authors.lastname: Pedersen
authors.affiliation: Department of Respiratory Diseases, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark.|The Clinical Institute, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark.
authors.forename: Ulla Møller
authors.initials: UM
authors.lastname: Weinreich
authors.affiliation: Department of Business and Management, Danish Center for Healthcare Improvements, Aalborg University, Fibigerstræde 11, 9220, Aalborg, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Ehlers
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019090:Case Management / Q000191:economics* / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis / Q000191:economics* / Q000706:statistics & numerical data*; D003718:Denmark; D005260:Female; D006801:Humans; D057187:Independent Living / Q000191:economics* / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000191:economics* / Q000628:therapy*; D019057:Quality-Adjusted Life Years