Cost-utility of triple versus dual inhaler therapy in moderate to severe asthma

BMC Pulmonary Medicine

Diana Guerrero Patiño¹  Jefferson Antonio Buendía² 

[1] Hospital Infantil Concejo de Medellín, Medellín, Colombia;Research Group in Pharmacology and Toxicology “INFARTO”, Department of Pharmacology and Toxicology, University of Antioquia, Medellín, Colombia;Facultad de Medicina, Universidad de Antioquia, Carrera 51D #62-29, Medellín, Colombia;

关键词: Tiotropium;    Uncontrolled asthma;    Cost-effectiveness analysis;    Decision analysis;    Markov model;   

DOI  :  10.1186/s12890-021-01777-z

来源: Springer

【 摘 要 】

BackgroundAn important proportion of asthma patients remain uncontrolled despite using inhaled corticosteroids and long-acting beta-agonists. Clinical guidelines recommend, in these patients, using add-on long-acting muscarinic antagonists (triple therapy) to treatment with high doses of inhaled corticosteroids-long-acting beta2-agonist (dual therapy). The purpose of this study was to assess the cost-effectiveness of triple therapy versus dual therapy for patients with severe asthma.MethodsA probabilistic Markov model was created to estimate the cost and quality-adjusted life-years (QALYs) of patients with severe asthma in Colombia. Total costs and QALYS of dual and triple therapy were calculated over a lifetime horizon. Multiple sensitivity analyses were conducted. Cost-effectiveness was evaluated at a willingness-to-pay value of $19,000.ResultsThe model suggests a potential gain of 1.55 QALYs per patient per year on triple therapy with respect to dual therapy. We observed a difference of US$304 in discounted cost per person-year on triple therapy with respect to dual therapy. The incremental cost-effectiveness ratio was US$196 in the probabilistic model. In the sensitivity analysis, our base‐case results were robust to variations in all assumptions and parameters.ConclusionIn conclusion, triple therapy in patients with moderate-severe asthma was cost-effective. Using triple therapy emerges with our results as an alternative before using oral corticosteroids or biologics, especially in resource-limited settings.

【 授权许可】

CC BY