Search

Bhavesh Lakhotia,1 Ronan Mahon,1 Florian S Gutzwiller,2 Andriy Danyliv,1 Ivan Nikolaev,2 Praveen Thokala3 1Novartis Ireland Limited, Dublin, Ireland; 2Novartis Pharma, Basel, AG, Switzerland; 3PT Health Economics Ltd, Sheffield, UKCorrespondence: Ronan MahonTeam Head, Patient Access Services Product Lifecycle Services – Novartis Global Service Center Dublin, Vista Building, Elm Park Business Campus, Dublin 4, IrelandTel +353873647443Email ronan.mahon@novartis.comPurpose: Exacerbations drive outcomes and costs in chronic obstructive pulmonary disease (COPD). While patient-level (micro) simulation cost-effectiveness models have been developed that include exacerbations, such models are complex. We developed a novel, exacerbation-based model to assess the cost-effectiveness of indacaterol/glycopyrronium (IND/GLY) versus salmeterol/fluticasone (SFC) in COPD, using a Markov structure as a simplification of a previously validated microsimulation model.Methods: The Markov model included three health states: infrequent or frequent exacerbator (IE or FE; ≤ 1 or ≥ 2 moderate/severe exacerbations in prior 12 months, respectively), or death. The model used data from the FLAME study and was run over a 10-year horizon. Cycle length was 1 year, after which patients remained in the same health state or transitioned to another. Analysis was conducted from a Swedish payer’s perspective (Swedish healthcare costs, converted into Euros), with incremental costs and quality-adjusted life-years (QALYs) calculated (discounted 3% annually).Results: At all post-baseline timepoints, IND/GLY was associated with more patients in the IE health state and fewer patients in the FE and dead states relative to SFC. Over a 10-year period, IND/GLY was associated with a cost saving of € 1,887/patient, an incremental benefit of 0.142 QALYs, and an addition of 0.057 life-years, compared with SFC.Conclusion: This Markov model represents a novel cost-effectiveness analysis for COPD, with simpler methodology than prior microsimulation models, while retaining exacerbations as drivers of disease progression. In patients with COPD with a history of exacerbations in the previous year, IND/GLY is a cost-effective treatment option compared with SFC.Keywords: chronic obstructive pulmonary disease, indacaterol/glycopyrronium, cost-effective, exacerbation, Markov model

The descriptive statistics of the HRQOL assessed via EQ-5D-3Â L and its components and its difference between NGT and GDM groups. (DOC 57 kb)

Definition of the explanatory variables. (DOC 27 kb)

Article Previous gestational diabetes (GDM) is associated with a significant lifetime risk of type 2 diabetes. We assessed the performance of HbA1c and fasting plasma glucose (FPG) against 75g oral glucose tolerance testing (OGTT) for follow-up screening of these women. peer-reviewed

Bondarenko K, Danyliv A (2012) Preferences of people living with diabetes for the aspects of good pharmaceutical practice. Tobacco Control and Public Health in Eastern Europe 2 (Supplement 1, 2nd conference 'Economics, sociology, theory and practice of public health'):s23-s24 Conference abstract Preferences of people living with diabetes for the aspects of good pharmaceutical practice Bondarenko, Kseniia; Danyliv, Andriy BACKGROUND: People living with diabetes (PLD) have special needs which could be effectively and efficiently addressed at the stage of pharmaceutical care. We analyzed preferences of PLD in Kyiv for services that could be potentially implemented in a specialized pharmacy. METHODS: We used a discrete choice experiment (DCE) to elicit preferences for pharmacist’s consultation, possibility of testing, and the availability of special products. The pharmacy was described with 3 attributes having 2 levels and 2 attributes having 3 levels. The analysis is based on interviews with 98 PLD. Respondents were recruited either in the in-patient unit of Kyiv endocrinology center or through snow-ball approach between January 2012 and March 2012. The DCE part consisted of 12 choice tasks (orthogonal fractional factorial design). To reduce the number of choices per respondent, the DCE was split into two experiments of 6 choices each. Respondents were randomly assigned to either DCE. Logistic regression xtlogit was used to model DCE responses using STATA version 11.0. RESULTS: Pharmacist’s consultation regarding the use of drugs, their compatibility, and special diet was the most important choice factor among PLD (marginal willingness to pay (MWTP) was 23.38 UAH), followed by the possibility of controlling the blood pressure, blood sugar and cholesterol levels, (MWTP is 21.68 UAH) and the availability of specialized products (MWTP is 13.57 UAH). Time for purchase (including travel and waiting) did not significantly affect the choice of pharmacy. CONCLUSIONS: Respondents gave mostly meaningful answers to the DCE and the model is theoretically valid. PLD are willing to spend time on traveling to the specialized pharmacy with Good Pharmacy Practice services. Conclusively, introduction of the pharmacy with special focus on PLD has good potential in Kyiv as they are ready to spend additional time and money to obtain proper services. KEYWORDS: Patient preferences, discrete choice experiment, Good Pharmaceutical Practice for people with diabetes, willingness to pay. Abstract (pdf) in English and Ukrainian

BACKGROUND: People living with diabetes (PLD) have special needs which could be effectively and efficiently addressed at the stage of pharmaceutical care. We analyzed preferences of PLD in Kyiv for services that could be potentially implemented in a specialized pharmacy.METHODS: We used a discrete choice experiment (DCE) to elicit preferences for pharmacist’s consultation, possibility of testing, and the availability of special products. The pharmacy was described with 3 attributes having 2 levels and 2 attributes having 3 levels. The analysis is based on interviews with 98 PLD. Respondents were recruited either in the in-patient unit of Kyiv endocrinology center or through snow-ball approach between January 2012 and March 2012. The DCE part consisted of 12 choice tasks (orthogonal fractional factorial design). To reduce the number of choices per respondent, the DCE was split into two experiments of 6 choices each. Respondents were randomly assigned to either DCE. Logistic regression xtlogit was used to model DCE responses using STATA version 11.0. RESULTS: Pharmacist’s consultation regarding the use of drugs, their compatibility, and special diet was the most important choice factor among PLD (marginal willingness to pay (MWTP) was 23.38 UAH), followed by the possibility of controlling the blood pressure, blood sugar and cholesterol levels, (MWTP is 21.68 UAH) and the availability of specialized products (MWTP is 13.57 UAH). Time for purchase (including travel and waiting) did not significantly affect the choice of pharmacy.CONCLUSIONS: Respondents gave mostly meaningful answers to the DCE and the model is theoretically valid. PLD are willing to spend time on traveling to the specialized pharmacy with Good Pharmacy Practice GPP services. Conclusively, introduction of the pharmacy with special focus on PLD has good potential in Kyiv as they are ready to spend additional time and money to obtain proper services.