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영어

BACKGROUND AND OBJECTIVE The quality of life (QoL) of patients with chronic disease could be lowered by the lack of their education and limited understanding about the treatment and disease. QoL is important for the treatment success because low QoL may negatively affect patients’ treatment or drug adherence. Thus, the “Chronic Disease Management (CDM)” program was implemented to help patients improve their QoL and treatment adherence in Korea. This study was aimed to evaluate the cost-utility outcome of a hypothetical CDM program for hypertension and diabetes patients. METHOD We conducted cost-utility analysis of the CDM program for both the registered and non-registered groups at baseline, 1-, 4- and 10-year follow ups with a limited social perspective. The costs for operating CDM program and direct/indirect medical cost were discounted at 5%. The main outcome measure was incremental cost-utility ratio (ICUR). Sensitivity analyses for discount rate were performed to assess the robustness of the results. RESULTS The CDM program increased patients’ QALYs by 0.044 per patient (from 0.902 to 0.946). The incremental cost was 237,431 won per person and the ICUR was 2,762,950 won/QALY. In addition, when the ICUR is calculated by reflecting the reduction cost for 10 years after the completion of CDM program, the ICUR becomes negative from 4 years later. ICUR/GDP is 0.29 at the first year of CDM program. DISCUSSION AND CONCLUSION This study showed that the CDM program could be cost-effective for patients with hypertension and diabetes. We suggest the current CDM program to be expanded in Korea.