Patient Heterogeneity in Health Economic Decision Models for Chronic Obstructive Pulmonary Disease: Are Current Models Suitable to Evaluate Personalized Medicine?

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift


Objectives To assess how suitable current chronic obstructive pulmonary disease (COPD) cost-effectiveness models are to evaluate personalized treatment options for COPD by exploring the type of heterogeneity included in current models and by validating outcomes for subgroups of patients. Methods A consortium of COPD modeling groups completed three tasks. First, they reported all patient characteristics included in the model and provided the level of detail in which the input parameters were specified. Second, groups simulated disease progression, mortality, quality-adjusted life-years (QALYs), and costs for hypothetical subgroups of patients that differed in terms of sex, age, smoking status, and lung function (forced expiratory volume in 1 second [FEV1] % predicted). Finally, model outcomes for exacerbations and mortality for subgroups of patients were validated against published subgroup results of two large COPD trials. Results Nine COPD modeling groups participated. Most models included sex (seven), age (nine), smoking status (six), and FEV1% predicted (nine), mainly to specify disease progression and mortality. Trial results showed higher exacerbation rates for women (found in one model), higher mortality rates for men (two models), lower mortality for younger patients (four models), and higher exacerbation and mortality rates in patients with severe COPD (four models). Conclusions Most currently available COPD cost-effectiveness models are able to evaluate the cost-effectiveness of personalized treatment on the basis of sex, age, smoking, and FEV1% predicted. Treatment in COPD is, however, more likely to be personalized on the basis of clinical parameters. Two models include several clinical patient characteristics and are therefore most suitable to evaluate personalized treatment, although some important clinical parameters are still missing.


  • Martine Hoogendoorn
  • Talitha L. Feenstra
  • Yumi Asukai
  • Andrew H. Briggs
  • Sixten Borg
  • Roberto W. Dal Negro
  • Ryan N. Hansen
  • Sven Arne Jansson
  • Reiner Leidl
  • Nancy Risebrough
  • Yevgeniy Samyshkin
  • Margarethe E. Wacker
  • Maureen P M H Rutten-van Mölken
Enheter & grupper
Externa organisationer
  • Erasmus University Rotterdam
  • University of Groningen
  • IMS Health
  • University of Glasgow
  • IHE – The Swedish Institute for Health Economics
  • Evidera Ltd
  • University of Washington
  • Umeå University
  • Helmholtz Zentrum München
  • National Institute for Public Health and the Environment (RIVM)
  • National Center for Respiratory Pharmacoeconomics and Pharmacoepidemiology
  • ICON Health Economics

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi


Sidor (från-till)800-810
Antal sidor11
TidskriftValue in Health
Utgåva nummer6
StatusPublished - 2016 sep 1
Peer review utfördJa


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