Indacaterol/glycopyrronium is cost-effective compared to salmeterol/fluticasone in COPD : FLAME-based modelling in a Swedish population
(2017) In Respiratory Research 18(1).- Abstract
Background: This 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. Methods: A 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... (More)
Background: This 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. Methods: A 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. Results: IND/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. Conclusion: IND/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.
(Less)
- author
- Bjermer, Leif LU ; van Boven, Job F.M. ; Costa-Scharplatz, Madlaina ; Keininger, Dorothy L. ; Gutzwiller, Florian S. ; Lisspers, Karin ; Mahon, Ronan ; Olsson, Petter and Roche, Nicolas
- organization
- publishing date
- 2017-12-11
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Chronic obstructive pulmonary disease, Cost-effective, Exacerbation, Indacaterol/glycopyrronium
- in
- Respiratory Research
- volume
- 18
- issue
- 1
- article number
- 206
- publisher
- BioMed Central (BMC)
- external identifiers
-
- pmid:29228950
- wos:000417884800001
- scopus:85037680053
- ISSN
- 1465-9921
- DOI
- 10.1186/s12931-017-0688-5
- language
- English
- LU publication?
- yes
- id
- 2f274ec7-ef2d-4584-baf2-f5cf005750b5
- date added to LUP
- 2018-01-04 12:42:37
- date last changed
- 2024-02-13 12:01:53
@article{2f274ec7-ef2d-4584-baf2-f5cf005750b5,
abstract = {{<p>Background: This 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. Methods: A 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. Results: IND/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. Conclusion: IND/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.</p>}},
author = {{Bjermer, Leif and van Boven, Job F.M. and Costa-Scharplatz, Madlaina and Keininger, Dorothy L. and Gutzwiller, Florian S. and Lisspers, Karin and Mahon, Ronan and Olsson, Petter and Roche, Nicolas}},
issn = {{1465-9921}},
keywords = {{Chronic obstructive pulmonary disease; Cost-effective; Exacerbation; Indacaterol/glycopyrronium}},
language = {{eng}},
month = {{12}},
number = {{1}},
publisher = {{BioMed Central (BMC)}},
series = {{Respiratory Research}},
title = {{Indacaterol/glycopyrronium is cost-effective compared to salmeterol/fluticasone in COPD : FLAME-based modelling in a Swedish population}},
url = {{http://dx.doi.org/10.1186/s12931-017-0688-5}},
doi = {{10.1186/s12931-017-0688-5}},
volume = {{18}},
year = {{2017}},
}