Cost-effectiveness of population-based screening for chronic obstructive pulmonary disease in China

• Verfasst von: Chen, Qiushi [VerfasserIn]
• Verfasst von: Fan, Yiwen [VerfasserIn]
• Verfasst von: Huang, Ke [VerfasserIn]
• Verfasst von: Li, Wei [VerfasserIn]
• Verfasst von: Geldsetzer, Pascal [VerfasserIn]
• Verfasst von: Bärnighausen, Till [VerfasserIn]
• Verfasst von: Yang, Ting [VerfasserIn]
• Verfasst von: Wang, Chen [VerfasserIn]
• Verfasst von: Chen, Simiao [VerfasserIn]
• Titel: Cost-effectiveness of population-based screening for chronic obstructive pulmonary disease in China
• Titelzusatz: a simulation modeling study
• Verf.angabe: Qiushi Chen, Yiwen Fan, Ke Huang, Wei Li, Pascal Geldsetzer, Till Bärnighausen, Ting Yang, Chen Wang and Simiao Chen
• E-Jahr: 2024
• Jahr: May 2024
• Umfang: 13 S.
• Illustrationen: Diagramme
• Fussnoten: Gesehen am 28.01.2025
• Titel Quelle: Enthalten in: The lancet. Regional Health. Western Pacific
• Ort Quelle: [Amsterdam] : Elsevier, 2020
• Jahr Quelle: 2024
• Band/Heft Quelle: 46(2024) vom: Mai, Artikel-ID 101065, Seite 1-13
• ISSN Quelle: 2666-6065
• DOI: doi:10.1016/j.lanwpc.2024.101065
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Chronic obstructive pulmonary disease
• Sach-SW: Cost-effectiveness analysis
• Sach-SW: Microsimulation
• Sach-SW: Population-based screening
• Sach-SW: Public health policy
• K10plus-PPN: 1915742269

Abstract

Background - China has the highest disease burden of chronic obstructive pulmonary disease (COPD) in the world; however, the diagnosis rate remains low. Screening for COPD in the population may improve early diagnosis and long-term health outcomes for patients with COPD. In this study, we aimed to evaluate the cost-effectiveness of population-based COPD screening policies in China. - Methods - We developed a microsimulation model that simulated incidence, natural history, and clinical management of COPD over a lifetime horizon among the general population aged 35-80 years in China. We evaluated population-based screening policies with different screening methods (one-step with COPD Screening Questionnaire or two-step with additional portable spirometer test) and frequencies (one-time or every 1-10 years). We calculated the incremental cost-effectiveness ratio (ICER) of the screening policies compared with the status quo (without screening) and identified the most cost-effective screening policy. Scenario and sensitivity analyses were performed to assess the impact of key parameters and the robustness of model results. - Findings - Compared with the status quo, all population-based COPD screening policies were cost-effective with estimated ICERs ranging between $8034 and $13,209 per quality-adjusted-life-year (QALY), all under the willingness-to-pay value of $38,441/QALY (three times China's gross domestic product per capita). A total of 0.39%-8.10% of COPD-related deaths and 0.58%-2.70% of COPD exacerbations were projected to be averted by COPD screening. Among all screening policies, annual two-step screening was the most cost-effective. Improving the linkage from screening to diagnosis and treatment could further increase population health benefits and the cost-effectiveness of COPD screening. - Interpretation - Population-based screening for COPD could be cost-effective in China. Offering public programs for COPD screening similar to existing preventive health services for other chronic diseases could be a promising strategy to improve population health outcomes and mitigate the disease burden of COPD in China. - Funding - Alexander von Humboldt Foundation, National Natural Science Foundation of China, CAMS Innovation Fund for Medical Science, Chinese Academy of Engineering project, and Horizon Europe.