Future Impact of Various Interventions on the Burden of COPD in Canada A Dynamic Population Model 英文参考文献.docVIP

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Future Impact of Various Interventions on the Burden of COPD in Canada A Dynamic Population Model 英文参考文献.doc

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Future Impact of Various Interventions on the Burden of COPD in Canada A Dynamic Population Model 英文参考文献

FutureImpactofVariousInterventionsontheBurdenof COPDinCanada:ADynamicPopulationModel MehdiNajafzadeh1,CarloA.Marra2,3,LarryD.Lynd2,3,MohsenSadatsafavi2,3,J.MarkFitzGerald4,6 BruceMcManus5,6,DonSin4,6 , * 1DepartmentofMedicine,HarvardMedicalSchool,Boston,Massachusetts,UnitedStatesofAmerica,2FacultyofPharmaceuticalSciences,UniversityofBritishColumbia, Vancouver, British Columbia, Canada, 3Centre for Health Evaluation and Outcome Sciences, St. Paul’s Hospital, Vancouver, British Columbia, Canada, 4Division of Respiratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada, 5Department of Pathology and Laboratory Medicine, University of British Columbia,andThePreventionofOrganFailureCenterofExcellence,Vancouver,BritishColumbia,Canada,6TheInstituteforHeartandLungHealth(theUBCJamesHogg ResearchLaboratories),Vancouver,BritishColumbia,Canada Abstract Background:Chronicobstructivepulmonarydisease(COPD)isagrowingeconomicburdenworldwide.Smokingcessation isthoughttobethesinglemosteffectivewayofreducingtheeconomicburdenofCOPD.Theimpactofotherstrategies such as interventions that predict risk of disease, reduce progression of disease, or reduce exacerbations has not been systematicallystudied. Objectives:WeestimatedtheeconomicandclinicalburdenofCOPDoverthenext25yearsinCanadaandtheimpactof threepotentialinterventions(screeningtestforpredispositiontoCOPD,newdrugstoavoidprogressionintomoresevere diseasestages,andpredictivetestforexacerbations)onCOPDburden. Methods:Usingadynamicsimulationmodel,weprojectedthetotalburdenofCOPD(cost,morbidity,andmortality)from 2011to2035usingthepopulationofCanadaasacasestudy.Themodelstratifiedpopulationbasedonsex,age,smoking status,respiratorysymptoms,andtheirCOPDstage.Thecostandqualityadjustedlifeyears(QALYs)associatedwitheach interventionwereestimated. Results:ThemodelindicatesthatannualsocietalcostofCOPDis$4.52billion(B)Canadiandollarsin2011andwillreach $3.61B($7.33Bundiscounted)peryearin2035.Overthenext25years,COPDwillber