Huo, Dacheng orcid.org/0009-0009-4204-5323, Hinde, Sebastian orcid.org/0000-0002-7117-4142, Smith, Harriet et al. (2 more authors) (Accepted: 2025) Modelling the case for cost-effectiveness of interventions to improve medication adherence in patients with difficult to control asthma. NIHR Open Research. 8. ISSN 2633-4402 (In Press)
Abstract
Background Asthma significantly impacts the United Kingdom, affecting approximately 12% of its population. Patient adherence to asthma therapies is a critical challenge, with research indicating a direct link between poor adherence and increased acute asthma episodes, contributing to worse patient health and substantial costs to the NHS. These incidents are notably correlated with socioeconomic factors, suggesting broader systemic issues influencing treatment adherence. This study aims to explore the cost-effectiveness of interventions designed to improve asthma treatment adherence. The developed model will support the development and implementation of cost-effective interventions to increase adherence to asthma medication. Methods Building on a previously developed decision model structure and incorporating expert clinical input, this study simulates the health status and associated healthcare resource implications of asthma patients over a 20-year period across various adherence scenarios. The model delineates three asthma control states: controlled, partially controlled, and uncontrolled. Age-adjusted utilities and comprehensive healthcare resource utilization data were incorporated, aligning resource use with recent national unit costs and adjusting for inflation. Treatment effectiveness is modeled exponentially in relation to adherence rates, allowing the model to flexibly compare the cost-effectiveness of interventions that improve adherence at different levels. In addition to conventional outputs from a cost-effectiveness decision model—such as expected health profiles and healthcare cost implications for different adherence levels—this study also presents estimates of asthma control and exacerbation rates to inform commissioning decisions. Results Initial analyses indicate that improving asthma medication adherence rates has the potential to:Generate additional patient health benefits, measured in terms of asthma control levels, life expectancy, and quality-adjusted life years (QALYs).Reduce the cost of care to the healthcare system.These findings demonstrate the substantial impact of adherence rates on both economic and health outcomes. Limitations and Implications The study faces limitations in generalizing adherence, as it does not account for the diverse contexts and scenarios of different adherence improvement interventions. Additionally, variations in adherence definitions across studies pose challenges for comparison. However, the study provides a flexible model that enables stakeholders to estimate the cost-effectiveness of interventions with varying effects on adherence levels. By focusing on patient- or user-centered research, this model serves as a valuable tool for policymakers and carers. It highlights the cost-effectiveness of enhancing asthma treatment adherence and underscores the need for targeted interventions that address socioeconomic disparities in healthcare.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2025 Huo D et al. |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Social Sciences (York) > Centre for Health Economics (York) |
Depositing User: | Pure (York) |
Date Deposited: | 03 Apr 2025 13:50 |
Last Modified: | 17 Apr 2025 23:09 |
Published Version: | https://doi.org/10.3310/nihropenres.13775.1 |
Status: | In Press |
Refereed: | No |
Identification Number: | 10.3310/nihropenres.13775.1 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:225175 |
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Filename: 219d7d51-88a2-4d1e-98ff-4764125205f2_13775_-_dacheng_huo.pdf
Description: Modelling the case for cost-effectiveness of interventions to improve medication adherence in patients with difficult to control asthma [version 1; peer review: awaiting peer review]
Licence: CC-BY 2.5