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Cost-effectiveness of roflumilast as an add-on to triple inhaled therapy vs triple inhaled therapy in patients with severe and very severe COPD associated with chronic bronchitis in the UK.
- Source :
-
International journal of chronic obstructive pulmonary disease [Int J Chron Obstruct Pulmon Dis] 2018 Sep 03; Vol. 13, pp. 2707-2720. Date of Electronic Publication: 2018 Sep 03 (Print Publication: 2018). - Publication Year :
- 2018
-
Abstract
- Purpose: Patients with severe COPD are at high risk of experiencing disease exacerbations, which require additional treatment and are associated with elevated mortality and increased risk of future exacerbations. Some patients continue to experience exacerbations despite receiving triple inhaled therapy (ICS plus LAMA plus LABA). Roflumilast is recommended by the Global Initiative for Chronic Obstructive Lung Disease as add-on treatment to triple inhaled therapy for these patients. This cost-effectiveness analysis compared costs and quality-adjusted life-years for roflumilast plus triple inhaled therapy vs triple inhaled therapy alone, using data from the REACT and RE <superscript>2</superscript> SPOND trials.<br />Patients and Methods: Patients included in the analysis had severe to very severe COPD, FEV <subscript>1</subscript> <50% predicted, symptoms of chronic bronchitis and ≥2 exacerbations per year. Our model was adapted from a previously published and validated model, and the analyses conducted from a UK National Health Service perspective. A scenario analysis considered a subset of patients who had experienced at least one COPD-related hospitalization within the previous year.<br />Results: Roflumilast as add-on to triple inhaled therapy was associated with non-significant reductions in rates of both moderate and severe exacerbations compared with triple inhaled therapy alone. The incremental cost-effectiveness ratio (ICER) for roflumilast as add-on to triple inhaled therapy was £24,976. In patients who had experienced previous hospitalization, roflumilast was associated with a non-significant reduction in the rate of moderate exacerbations, and a statistically significant reduction in the rate of severe exacerbations. The ICER for roflumilast in this population was £7,087.<br />Conclusions: Roflumilast is a cost-effective treatment option for patients with severe or very severe COPD, chronic bronchitis, and a history of exacerbations. The availability of roflumilast as add-on treatment addresses an important unmet need in this patient population.
- Subjects :
- Administration, Inhalation
Aged
Aminopyridines administration & dosage
Benzamides administration & dosage
Bronchitis, Chronic complications
Bronchitis, Chronic mortality
Bronchodilator Agents administration & dosage
Cost-Benefit Analysis
Cyclopropanes administration & dosage
Cyclopropanes economics
Disease Progression
Drug Therapy, Combination economics
Drug Therapy, Combination methods
Female
Hospitalization
Humans
Male
Middle Aged
Phosphodiesterase 4 Inhibitors administration & dosage
Pulmonary Disease, Chronic Obstructive complications
Pulmonary Disease, Chronic Obstructive mortality
Quality-Adjusted Life Years
United Kingdom
Aminopyridines economics
Benzamides economics
Bronchitis, Chronic drug therapy
Bronchodilator Agents economics
Phosphodiesterase 4 Inhibitors economics
Pulmonary Disease, Chronic Obstructive drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1178-2005
- Volume :
- 13
- Database :
- MEDLINE
- Journal :
- International journal of chronic obstructive pulmonary disease
- Publication Type :
- Academic Journal
- Accession number :
- 30214188
- Full Text :
- https://doi.org/10.2147/COPD.S167730