Title |
Cost-Effectiveness of Fixed-Dose Combinations Therapies for Chronic Obstructive Pulmonary Disease Treatment
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Published in |
Clinical Drug Investigation, April 2018
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DOI | 10.1007/s40261-018-0646-0 |
Pubmed ID | |
Authors |
Margarita Capel, María Mareque, Carlos José Álvarez, Leandro Lindner, Itziar Oyagüez |
Abstract |
Chronic obstructive pulmonary disease (COPD), a progressive lung disorder associated with decline of respiratory function, affects 10.2% of Spanish adults (40-80 years of age). This study aimed to assess the cost-effectiveness of two fixed-dose combinations of long-acting muscarinic antagonist and long-acting β2-agonist therapies for COPD, with Spanish National Health System perspective. A Markov model with five health states based on severity levels defined by GOLD 2010 criteria was used to simulate in monthly cycles the evolution along a 5-year period of a cohort of moderate-to-severe COPD patients, treated with aclidinium-formoterol (ACL/FF) 400/12 µg or tiotropium-olodaterol (TIO/OLO) 5/5 µg fixed-dose combinations. Clinical data on lung-function improvement were obtained from a network meta-analysis and applied to mean baseline forced-expiratory-volume in 1 s (FEV1) for the first 24-weeks period. Natural history for lung-function decline (41 ml/year) was applied until the end of simulation. Risk of exacerbation and pneumonia occurrence were considered. Pharmaceutical costs were calculated with dosages according to indication and public ex-factory prices. The health state-specific disease management and event costs, and utilities were derived from the literature. Total costs (€ 2016) and benefits [life-year-gained (LYG) and quality-adjusted-life-year (QALY)] were discounted (3.0% yearly). Sensitivity analyses were performed. Both therapies provided the same outcomes (4.073 LYG and 2.928 QALY) at 5-year period. ACL/FF 400/12 µg provided marginally lower costs (€ - 332) compared to TIO/OLO 5/5 µg. ACL/FF 400/12 µg was a cost-saving therapy in patients with moderate-to-severe COPD in Spain, and provided equivalent effects compared to TIO/OLO 5/5 µg. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 52 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 8 | 15% |
Other | 7 | 13% |
Researcher | 7 | 13% |
Student > Ph. D. Student | 6 | 12% |
Student > Bachelor | 4 | 8% |
Other | 7 | 13% |
Unknown | 13 | 25% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 13 | 25% |
Nursing and Health Professions | 7 | 13% |
Pharmacology, Toxicology and Pharmaceutical Science | 5 | 10% |
Economics, Econometrics and Finance | 4 | 8% |
Psychology | 2 | 4% |
Other | 4 | 8% |
Unknown | 17 | 33% |