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Canadian Respiratory Journal
Volume 8 (2001), Issue 1, Pages 27-33
Original Article

Economic Impact of Using an Immunostimulating Agent to Prevent Severe Acute Exacerbations in Patients with Chronic Obstructive Pulmonary Disease

Jean-Paul Collet,1,2 Thierry Ducruet,1 Seema Haider,3 Stan Shapiro,1,2 Ann Robinson,1 Paolo M Renzi,4,5 André-Pierre Contandriopoulos,5,6 and Pierre Ernst2,3

1Centre for Clinical Epidemiology and Community Studies, SMBD Jewish General Hospital, Montréal, Québec, Canada
2Department of Epidemiology and Biostatistics, McGill University, Montréal, Québec, Canada
3Respiratory Division, McGill University Health Centre, Montréal, Québec, Canada
4Centre Hospitalo-Universitaire de Montréal, Pavillon Notre Dame, Département de Pneumologie, Montréal, Québec, Canada
5Université de Montréal, Montréal, Québec, Canada
6Groupe de Recherche Interdisciplinaire en Santé, Université de Montréal, Montréal, Québec, Canada

Copyright © 2001 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


RATIONALE: OM-85 BV, an immunostimulant made from bacterial extracts, has been shown to reduce the risk of hospitalization for acute exacerbation in patients with chronic obstructive pulmonary disease, as well as to reduce the length of stay for all hospitalizations.

METHODS: In conjunction with a placebo controlled, randomized clinical trial, a cost effectiveness analysis was carried out to assess the economic impact of using OM-85 BV. In the analysis, effectiveness was defined as the difference in the number of severe acute exacerbations, assessed by the number of hospitalizations for a respiratory problem, between the placebo and OM-85 BV-treated groups.

RESULTS: The median cost to prevent one day of hospitalization for a respiratory condition was CDN$45, with a 95% CI of CDN$18 to CDN$210. Bootstrap of the study population and sensitivity analyses showed that the results were robust and not likely due to random fluctuation; 98.8% of the cost effectiveness and 96.8% of the cost-benefit ratios favoured the use of OM-85 BV. Indirect costs, defined as a need for help, were reduced by 36% in the group treated with OM-85 BV: 779 h of help compared with 1212 h in the placebo group. This trend, while not significant, is consistent with other results and suggests a decrease in the severity of exacerbations in the OM-85 BV-treated group.

CONCLUSION: Given the high prevalence of chronic obstructive pulmonary disease worldwide and the high cost of acute exacerbations, immunostimulants may become a key element in the improved control of this condition.