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Respir Res. 2018 May 9;19(1):84. doi: 10.1186/s12931-018-0796-x.

Cost-effectiveness of lung volume reduction coil treatment in patients with severe emphysema: results from the 2-year follow-up crossover REVOLENS study (REVOLENS-2 study).

Author information

1
AP-HP URC Eco IdF, Unité de recherche clinique en économie de la santé d'Ile de France, Paris, France. julie.bulsei@urc-eco.fr.
2
Service de Pneumologie, CHU de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France.
3
Service de Pneumologie, INSERM U1250, Hôpital Universitaire, Reims, France.
4
Service de Pneumologie, Hôpital Universitaire Bichat, Paris, France.
5
Service d'Oncologie Thoracique, Maladies de la Plèvre, Pneumologie Interventionnelle, Hôpital Universitaire, Marseille, France.
6
Département de Pneumologie et Addictologie, PhyMedExp, INSERM U1046, CNRS UMR, Hôpital Universitaire, Montpellier, France.
7
Service de Pneumologie, Hôpital Universitaire, Saint Etienne, France.
8
Pôle Thorax et Vaisseaux, Inserm1055, Hôpital Universitaire Grenoble Alpes, Inserm1055, Université Grenoble Alpes, Grenoble, France.
9
Service de Pneumologie, Hôpital Universitaire, Strasbourg, France.
10
Service de Pneumologie, Hôpital Universitaire, Amiens, France.
11
Service de Pneumologie, Oncologie Thoracique et Soins Intensifs Respiratoires, Hôpital Universitaire, Rouen, France.
12
Département de Pharmacovigilance, Hôpital Universitaire de Reims, Reims, France.
13
Unité d'Aide Méthodologique, Pôle Recherche et Santé Publique, Hôpital Universitaire de Reims, Reims, France.
14
Centre de Recherche et d'Investigation Clinique, Pôle Recherche et Santé Publique, Hôpital Universitaire de Reims, Reims, France.
15
AP-HP URC Eco IdF, Unité de recherche clinique en économie de la santé d'Ile de France, Paris, France.

Abstract

BACKGROUND:

The REVOLENS study compared lung volume reduction coil treatment to usual care in patients with severe emphysema at 1 year, resulting in improved quality-adjusted life-year (QALY) and higher costs. Durability of the coil treatment benefit and its cost-effectiveness at 2 years are now assessed.

METHODS:

After one year, the REVOLENS trial's usual care group patients received coil treatment (second-line coil treatment group). Costs and QALYs were assessed in both arms at 2 years and an incremental cost-effectiveness ratio in cost per QALY gained was calculated. The uncertainty of the results was estimated by probabilistic bootstrapping.

RESULTS:

The average cost of coil treatment in both groups was estimated at €24,356. The average total cost at 2 years was €9655 higher in the first-line coil treatment group (p = 0.07) and the difference in QALY between the two groups was 0.127 (p = 0.12) in favor of first-line coil treatment group. The 2-year incremental cost-effectiveness ratio (ICER) was €75,978 / QALY. The scatter plot of the probabilistic bootstrapping had 92% of the replications in the top right-hand quadrant.

CONCLUSION:

First-line coil treatment was more expensive but also more effective than second-line coil treatment at 2 years, with a 2-year ICER of €75,978 / QALY.

TRIAL REGISTRATION:

ClinicalTrials.gov Identifier NCT01822795 .

KEYWORDS:

Coil treatment; Cost-effectiveness; QALY; Severe emphysema

PMID:
29743071
PMCID:
PMC5941693
DOI:
10.1186/s12931-018-0796-x
[Indexed for MEDLINE]
Free PMC Article

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