Cost-Effectiveness Analysis of Triple Therapy with Budesonide/ Glycopyrronium/ Formoterol Fumarate versus Dual Therapy in Patients with Chronic Obstructive Pulmonary Disease in Spain
Por:
Trigueros, JA, Garin, N, Baloira, A, Aceituno, S, Calvo, A, Prades, M, Touron, C, Martinez, A, Torres, C
Publicada:
1 ene 2022
Resumen:
Objective: To evaluate the cost-effectiveness of Budesonide/Glycopyrronium/Formoterol (BUD/GLY/FOR) versus LAMA/LABA and ICS/ LABA, respectively, in patients with moderate to severe COPD, from the Spanish National Healthcare System (NHS) perspective.Methods: A lifetime Markov model with monthly cycle length was developed with baseline and treatment effect data from ETHOS clinical trial, together with utility values from literature and Spanish healthcare resource costs ( euro , 2021). A 3% annual discount rate was used for costs and benefits. The model comprised ten health states: nine forced expiratory volume in 1 second (FEV1)-related, which were divided by three levels of severity: moderate (FEV1 >50% and <80%); severe (FEV1 >30% and <50%) and very severe (FEV1 <30%) and a death state. Each FEV1-health state was divided into no exacerbation, moderate exacerbation, and severe exacerbations. An expert panel validated data and assumptions. Outcomes were measured as incremental cost per exacerbation avoided, per life year (LY) gained, and per quality-adjusted life-year (QALY) gained (ICUR). One-way (OWSA), scenario, and probabilistic sensitivity analyses (PSA) were performed.Results: According to this cost-effectiveness analysis based on a Markov model, BUD/GLY/FOR was associated with a lower totals exacerbation per patient (12.80) compared to LAMA/LABA (13.36) and ICS/LABA (13.23) and higher LYs (10.32 vs 10.14 and 10.06, respectively) and QALYs (7.55 vs 7.41 and 7.32, respectively). The incremental costs were euro 850.95, and euro 2422.26, respec-tively, per exacerbation avoided, euro 2733.38 and euro 4111.15, respectively, per LY gained and euro 3461.19 and euro 4545.24 per QALY gained. OWSA showed that the model was most sensitive to the costs of treatments following discontinuation, but the ICUR remained below the cost-effectiveness threshold of euro 25,000 per QALY gained. In the PSA, the probability of BUD/GLY/FOR being cost-effective was 91.32% vs LAMA/LABA and 99.29% vs ICS/LABA.Conclusion: BUD/GLY/FOR is a cost-effective treatment strategy for Spanish NHS patients with COPD compared to dual therapies.
Filiaciones:
Trigueros, JA:
Castilla La Mancha Hlth Serv, Hlth Ctr Menasalbas, Toledo, Spain
Garin, N:
Hosp Santa Creu & Sant Pau, Pharm Dept, Barcelona, Spain
Baloira, A:
Univ Hosp Pontevedra, Resp Dept, Pontevedra, Spain
Aceituno, S:
Outcomes 10 SL, Hlth Econ & Outcomes Res, Castellon De La Plana, Spain
Calvo, A:
Outcomes 10 SL, Hlth Econ & Outcomes Res, Castellon De La Plana, Spain
Prades, M:
Outcomes 10 SL, Hlth Econ & Outcomes Res, Castellon De La Plana, Spain
Touron, C:
AstraZeneca Farmaceut Spain SA, Pricing&HEOR, Madrid, Spain
Martinez, A:
AstraZeneca Farmaceut Spain SA, Pricing&HEOR, Madrid, Spain
Torres, C:
AstraZeneca Farmaceut Spain SA, Pricing&HEOR, Madrid, Spain
gold, Green Published
|