Cost effectiveness of bronchial thermoplasty in patients with severe uncontrolled asthma

Zein, Joe; Menegay, Michelle; Singer, Mendel E.; Erzurum, Serpil C.; Gildea, Thomas R.; Cicenia, Joseph; Khatri, Sumita; Castro, Mario; Udeh, Belinda

doi:10.3109/02770903.2015.1072552

Cited by 35 publications

(26 citation statements)

References 23 publications

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“…Our results stand in contrast with those of Cangelosi et al . and Zein et al . who found BT‐OAT to be very cost‐effective relative to OAT (ICER of $US5495/QALY and $US29 821/QALY, respectively).…”

Section: Discussioncontrasting

confidence: 99%

“…and $US6690 in Zein et al .) . Moreover, the cost of an episode of exacerbation‐related hospitalization is roughly three times greater in the US compared with Singapore ($US9801 vs $US3340) while cost of an ED visit is nearly eight times higher ($US673 vs $US85).…”

Section: Discussionmentioning

confidence: 99%

“…standard of care) but their findings are mixed. [6][7][8] Further, while informative, the generalizability of these studies is questionable as they all utilize cost data from the US characterized by a unique combination of relatively low costs of the BT procedure 6 and relatively high costs of hospitalization. 9 As BT reduces the risk of exacerbation-related hospitalizations, cost of hospitalization (and BT procedure) greatly influences the costeffectiveness of BT.…”

Section: Oatmentioning

confidence: 99%

“…There is limited evidence on the cost‐effectiveness of BT. Only three studies have looked at the incremental cost‐effectiveness of BT treatment relative to optimized asthma therapy (OAT) (the current standard of care) but their findings are mixed . Further, while informative, the generalizability of these studies is questionable as they all utilize cost data from the US characterized by a unique combination of relatively low costs of the BT procedure and relatively high costs of hospitalization .…”

Section: Introductionmentioning

confidence: 99%

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Is bronchial thermoplasty cost‐effective as treatment for problematic asthma patients? Singapore's perspective on a global model

et al. 2017

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Background and objective: Bronchial thermoplasty (BT) has been shown to be effective at reducing asthma exacerbations and improving asthma control for patients with severe persistent asthma but it is also expensive. Evidence on its cost-effectiveness is limited and inconclusive. In this study, we aim to evaluate the incremental cost-effectiveness of BT combined with optimized asthma therapy (BT-OAT) relative to OAT for difficult-to-treat and severe asthma patients in Singapore, and to provide a general framework for determining BT's cost-effectiveness in other healthcare settings. Methods: We developed a Markov model to estimate the costs and quality-adjusted life years (QALYs) gained with BT-OAT versus OAT from the societal and health system perspectives. The model was populated using Singapore-specific costs and transition probabilities and utilities from the literature. Sensitivity analyses were conducted to identify the main factors determining cost-effectiveness of BT-OAT. Results: BT-OAT is not cost-effective relative to OAT over a 5-year time horizon with an incremental costeffectiveness ratio (ICER) of $US138 889 per QALY from the societal perspective and $US139 041 per QALY from the health system perspective. The cost-effectiveness of BT-OAT largely depends on a combination of the cost of the BT procedure and the cost of asthma-related hospitalizations and emergency department (ED) visits. Conclusion: Based on established thresholds for costeffectiveness, BT-OAT is not cost-effective compared with OAT in Singapore. Given its current clinical efficacy, BT-OAT is most likely to be cost-effective in a setting where the cost of BT procedure is low and costs of hospitalization and ED visits are high.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Oatmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Is bronchial thermoplasty cost‐effective as treatment for problematic asthma patients? Singapore's perspective on a global model

et al. 2017

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“…The study reported cost effectiveness of BT to be US$5,459 per quality-adjusted life year. A more recent study assessed the 10-year cost-effectiveness of BT for patients with severe uncontrolled asthma to be US$29,821 per quality-adjusted life year (22). When compared to the anti-IgE antibody therapy, omalizumab, a recent study demonstrated BT to be a potentially more cost effective option.…”

Section: Cost Effectivenessmentioning

confidence: 99%

Thermal ablation for asthma: current status and technique

Krmisky¹,

Sobieszczyk²,

Sarkar³

2017

J. Thorac. Dis.

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Bronchial thermoplasty (BT) is a novel technique used in the treatment of severe asthma.A catheter is advanced through the bronchoscope and directed radiofrequency waves are applied to the segmental bronchi to reduce airway smooth muscle mass. Several randomized clinical trials demonstrate improvement in quality of life and reduction in exacerbation rates after treatment. BT is a safe and cost effective treatment option for severe asthma which is refractory to medical treatment. Further studies are needed in order to better describe the mechanism of action and the asthma subphenotype that was best benefit from this treatment.

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Biomarkers, Targeted Therapies, Biologics, and Bronchial Thermoplasty

Mohan

Grace

Mainardi

et al. 2019

Difficult to Treat Asthma

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Cost effectiveness of bronchial thermoplasty in patients with severe uncontrolled asthma

Abstract: BT is a cost-effective treatment for asthmatics at high risk of exacerbations. Continuing to follow asthmatics treated with BT beyond 5 years will help inform longer efficacy and support its cost-effectiveness.

Cited by 35 publications

References 23 publications

Is bronchial thermoplasty cost‐effective as treatment for problematic asthma patients? Singapore's perspective on a global model

Is bronchial thermoplasty cost‐effective as treatment for problematic asthma patients? Singapore's perspective on a global model

Thermal ablation for asthma: current status and technique

Biomarkers, Targeted Therapies, Biologics, and Bronchial Thermoplasty

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