Cost-effectiveness of population-based screening for chronic obstructive pulmonary disease in China: a simulation modeling study
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 e...
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| Main Authors: | , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
May 2024
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| In: |
The lancet. Regional Health. Western Pacific
Year: 2024, Volume: 46, Pages: 1-13 |
| ISSN: | 2666-6065 |
| DOI: | 10.1016/j.lanwpc.2024.101065 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.lanwpc.2024.101065 Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S2666606524000592 
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| Author Notes: | Qiushi Chen, Yiwen Fan, Ke Huang, Wei Li, Pascal Geldsetzer, Till Bärnighausen, Ting Yang, Chen Wang and Simiao Chen |
| Summary: | 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. |
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| Item Description: | Gesehen am 28.01.2025 |
| Physical Description: | Online Resource |
| ISSN: | 2666-6065 |
| DOI: | 10.1016/j.lanwpc.2024.101065 |