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

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 (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.

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author
organization
publishing date
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
publisher
BioMed Central
external identifiers
  • scopus:85037680053
  • wos:000417884800001
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
2018-01-16 13:29:14
@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>},
  articleno    = {206},
  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},
  keyword      = {Chronic obstructive pulmonary disease,Cost-effective,Exacerbation,Indacaterol/glycopyrronium},
  language     = {eng},
  month        = {12},
  number       = {1},
  publisher    = {BioMed Central},
  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},
  volume       = {18},
  year         = {2017},
}