Indacaterol/glycopyrronium is cost-effective compared to salmeterol/fluticasone in COPD: FLAME-based modelling in a Swedish population

Respiratory Research

Research

Job F. M. van Boven¹  Karin Lisspers²  Leif Bjermer³  Ronan Mahon⁴  Dorothy L. Keininger⁵  Florian S. Gutzwiller⁵  Madlaina Costa-Scharplatz⁶  Petter Olsson⁶  Nicolas Roche⁷ 

[1] Department of General Practice, Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands;Unit of Pharmacoepidemiology & Pharmacoeconomics, Department of Pharmacy, University of Groningen, Groningen, The Netherlands;Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden;Department of Respiratory medicine & Allergology, Skane University Hospital, Lund University, Lund, Sweden;Novartis Ireland Limited, Dublin, Ireland;Novartis Pharma AG, Basel, Switzerland;Novartis Sverige AB, Täby, Sweden;Respiratory and Intensive Care Medicine, Cochin Hospital (AP-HP) and University Paris Descartes, Paris, France;

关键词: Chronic obstructive pulmonary disease;    Indacaterol/glycopyrronium;    Cost-effective;    Exacerbation;   

DOI  :  10.1186/s12931-017-0688-5

 received in 2017-07-06, accepted in 2017-11-23,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThis study assessed the cost-effectiveness of indacaterol/glycopyrronium (IND/GLY) versus salmeterol/fluticasone (SFC) in chronic obstructive pulmonary disease (COPD) patients with moderate to very severe airflow limitation and ≥1 exacerbation in the preceding year.MethodsA previously published and validated patient-level simulation model was adapted using clinical data from the FLAME trial and real-world cost data from the ARCTIC study. Costs (total monetary costs comprising drug, maintenance, exacerbation, and pneumonia costs) and health outcomes (life-years (LYs), quality-adjusted life-years (QALYs)) were projected over various time horizons (1, 5, 10 years, and lifetime) from the Swedish payer’s perspective and were discounted at 3% annually. Uncertainty in model input values was studied through one-way and probabilistic sensitivity analyses. Subgroup analyses were also performed.ResultsIND/GLY was associated with lower costs and better outcomes compared with SFC over all the analysed time horizons. Use of IND/GLY resulted in additional 0.192 LYs and 0.134 QALYs with cost savings of €1211 compared with SFC over lifetime. The net monetary benefit (NMB) was estimated to be €8560 based on a willingness-to-pay threshold of €55,000/QALY. The NMB was higher in the following subgroups: severe (GOLD 3), high risk and more symptoms (GOLD D), females, and current smokers.ConclusionIND/GLY is a cost-effective treatment compared with SFC in COPD patients with mMRC dyspnea grade ≥ 2, moderate to very severe airflow limitation, and ≥1 exacerbation in the preceding year.

【 授权许可】

CC BY   
© The Author(s). 2017