A Chronic Disease Management Model for Cirrhosis is Cost-Effective: Analysis of a Randomized Controlled Trial

Journal of Gastroenterology and Hepatology
Alan J WiggBillingsley Kaambwa

Abstract

Background and Aims In this follow-up study to a RCT of chronic a chronic disease management (CDM) model in cirrhosis, our aim was to assess the relative cost effectiveness of this model compared to usual care during the 12-month study period, using incremental costs per death avoided as the primary outcome. Mean differences in hospitalization costs, deaths avoided and change in Chronic Liver Disease Questionnaire (CLDQ) total scores were presented with 95% non-parametric bootstrapped confidence intervals. Results were also presented using a cost effectiveness plane (CEP) and cost effectiveness acceptability curve (CEAC). The CDM intervention was more expensive, by $18,521 per participant, but more effective (% of deaths at 12 months: 10 % vs. 15% and 0.67 units increase per patient in CLDQ total scores. The resultant incremental cost-effectiveness ratios (ICERs) were $370,425 per death avoided (95% CI: -$14,564 to $2,059,373) and $27,547 per unit improvement in the CLDQ total score (95% CI: $7,455 to $143,874). The CEPs demonstrated some uncertainly around cost-effectiveness. The CEACs demonstrated that at willingness to pay values of $400,000 per additional death avoided and $40,000 per unit improvement in the CLDQ, there was...Continue Reading

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Citations

Dec 20, 2019·Journal of Viral Hepatitis·Yinzong XiaoMargaret E Hellard
Sep 28, 2018·The Medical Journal of Australia·Timothy Papaluca, Alexander Jv Thompson

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