HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Related articles in AJPH Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hay, J W Articles by Robin, E D Search for Related Content PubMed PubMed Citation Articles by Hay, J W Articles by Robin, E D

Cost-effectiveness of alpha-1 antitrypsin replacement therapy in treatment of congenital chronic obstructive pulmonary disease.

J W Hay and E D Robin

Hoover Institution, Stanford University, CA 94305-6010.

BACKGROUND: Alpha 1-antitrypsin (AAT) replacement therapy is an expensive intervention ($20,000-$30,000 per patient annually) which may slow or arrest the progression of chronic obstructive pulmonary disease (COPD) in AAT-deficient patients. While FDA-approved, therapy efficacy is unknown. The costs and benefits of AAT replacement therapy were evaluated for patients with congenital COPD. METHODS: Epidemiological and disease cost data were taken from published sources. A discrete-time model of disease stage probability transition was developed to calculate the present-value expected cost of disease treatment, under a range of possible therapy efficacy and other parameter values. RESULTS: At an efficacy of 70 percent, the cost per life year saved with AAT replacement therapy would be between $28,000 and $72,000 (1990 US dollars), depending on patient age, sex, and smoking status. At 30 percent efficacy, the cost per life year saved range would be between $50,000 and $128,000. A controlled efficacy study would cost $53 million or less, if the true efficacy were 50 percent or better. CONCLUSIONS: With efficacy of 30 percent or higher, therapy cost-effectiveness would be comparable to other widely used medical interventions. The economic assessment methodology was used to evaluate both the therapeutic innovation and the value of additional clinical research.

Related articles in AJPH:

The cost-effectiveness of orphan drugs.

M C Weinstein
AJPH 1991 81: 414-415. [PDF]  

This article has been cited by other articles:

				S. G. Louie, D. A. Sclar, and M. A. Gill Aralast: A New {alpha}1-Protease Inhibitor for Treatment of {alpha}-Antitrypsin Deficiency Ann. Pharmacother., November 1, 2005; 39(11): 1861 - 1869. [Abstract] [Full Text] [PDF]

				J K Stoller and L S Aboussouan {alpha}1-Antitrypsin deficiency {middle dot} 5: Intravenous augmentation therapy: current understanding Thorax, August 1, 2004; 59(8): 708 - 712. [Abstract] [Full Text] [PDF]

				American Thoracic Society/European Respiratory Society Statement: Standards for the Diagnosis and Management of Individuals with Alpha-1 Antitrypsin Deficiency Am. J. Respir. Crit. Care Med., October 1, 2003; 168(7): 818 - 900. [Full Text] [PDF]

				C. D. Mullins, J. Wang, and J. K. Stoller Major Components of the Direct Medical Costs of {alpha}1-Antitrypsin Deficiency Chest, September 1, 2003; 124(3): 826 - 831. [Abstract] [Full Text] [PDF]

				T. R. Gildea, K. M. Shermock, M. E. Singer, and J. K. Stoller Cost-Effectiveness Analysis of Augmentation Therapy for Severe {alpha}1-Antitrypsin Deficiency Am. J. Respir. Crit. Care Med., May 15, 2003; 167(10): 1387 - 1392. [Abstract] [Full Text] [PDF]

				C. D. Mullins, X. Huang, S. Merchant, and J. K. Stoller The Direct Medical Costs of {{alpha}}1-Antitrypsin Deficiency Chest, March 1, 2001; 119(3): 745 - 752. [Abstract] [Full Text] [PDF]

				S. A. Alkins and P. O’Malley Should Health-Care Systems Pay for Replacement Therapy in Patients With {alpha}1-Antitrypsin Deficiency?: A Critical Review and Cost-Effectiveness Analysis Chest, March 1, 2000; 117(3): 875 - 880. [Abstract] [Full Text] [PDF]