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Cost-effectiveness analysis of umeclidinium/vilanterol for the management of patients with moderate to very severe COPD using an economic model.
Int J Chron Obstruct Pulmon Dis. 2017; 12:997-1008.IJ

Abstract

BACKGROUND

Bronchodilators such as long-acting muscarinic antagonists (LAMAs) and long-acting β2-agonists (LABAs) are central to the pharmacological management of COPD. Dual bronchodilation with umeclidinium/vilanterol (UMEC/VI; 62.5/25 μg) is a novel LAMA/LABA combination approved for maintenance treatment for patients with COPD.

OBJECTIVE

The objective of this study was to assess the cost-effectiveness of maintenance treatment with UMEC/VI compared with tiotropium (TIO) 18 μg, open dual LAMA + LABA treatment, or no long-acting bronchodilator treatment in patients with moderate to very severe COPD.

METHODS

A Markov model was developed to estimate the costs and outcomes associated with UMEC/VI treatment in patients with moderate to very severe COPD (GSK study number: HO-13-13411). Clinical efficacy, costs, utilities, and mortality obtained from the published literature were used as the model inputs. Costs are presented in US dollars based on 2015 prices. The model outputs are total costs, drug costs, other medical costs, number of COPD exacerbations, and quality-adjusted life-years (QALYs). Costs and outcomes were discounted at a 3% annual rate. Incremental cost-effectiveness ratios were calculated. One-way and probabilistic sensitivity analyses were conducted to assess the effects of changing parameters on the uncertainty of the results.

RESULTS

UMEC/VI treatment for moderate to very severe COPD was associated with lower lifetime medical costs ($82,344) compared with TIO ($88,822), open dual LAMA + LABA treatment ($114,442), and no long-acting bronchodilator ($86,751). Fewer exacerbations were predicted to occur with UMEC/VI treatment compared with no long-acting bronchodilator treatment. UMEC/VI provided an 0.11 and 0.25 increase in QALYs compared with TIO and no long-acting bronchodilator treatment, and as such, dominated these cost-effectiveness analyses. Sensitivity analyses confirmed that the results were robust.

CONCLUSION

The results from this model suggest that UMEC/VI treatment would be dominant compared with TIO and no long-acting bronchodilator treatment, and less costly than open dual LAMA + LABA treatment in patients with moderate to very severe COPD.

Authors+Show Affiliations

RTI Health Solutions, Research Triangle Park, NC, USA.GSK, Research Triangle Park, NC, USA; Amgen Inc., Thousand Oaks, CA, USA.GSK, Research Triangle Park, NC, USA.RTI Health Solutions, Research Triangle Park, NC, USA.GSK, Research Triangle Park, NC, USA.RTI Health Solutions, Research Triangle Park, NC, USA.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

28392684

Citation

Wilson, Michele R., et al. "Cost-effectiveness Analysis of Umeclidinium/vilanterol for the Management of Patients With Moderate to Very Severe COPD Using an Economic Model." International Journal of Chronic Obstructive Pulmonary Disease, vol. 12, 2017, pp. 997-1008.
Wilson MR, Patel JG, Coleman A, et al. Cost-effectiveness analysis of umeclidinium/vilanterol for the management of patients with moderate to very severe COPD using an economic model. Int J Chron Obstruct Pulmon Dis. 2017;12:997-1008.
Wilson, M. R., Patel, J. G., Coleman, A., McDade, C. L., Stanford, R. H., & Earnshaw, S. R. (2017). Cost-effectiveness analysis of umeclidinium/vilanterol for the management of patients with moderate to very severe COPD using an economic model. International Journal of Chronic Obstructive Pulmonary Disease, 12, 997-1008. https://doi.org/10.2147/COPD.S124420
Wilson MR, et al. Cost-effectiveness Analysis of Umeclidinium/vilanterol for the Management of Patients With Moderate to Very Severe COPD Using an Economic Model. Int J Chron Obstruct Pulmon Dis. 2017;12:997-1008. PubMed PMID: 28392684.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-effectiveness analysis of umeclidinium/vilanterol for the management of patients with moderate to very severe COPD using an economic model. AU - Wilson,Michele R, AU - Patel,Jeetvan G, AU - Coleman,Amber, AU - McDade,Cheryl L, AU - Stanford,Richard H, AU - Earnshaw,Stephanie R, Y1 - 2017/03/24/ PY - 2017/4/11/entrez PY - 2017/4/11/pubmed PY - 2017/10/24/medline KW - COPD KW - cost-effectiveness KW - tiotropium KW - umeclidinium KW - vilanterol SP - 997 EP - 1008 JF - International journal of chronic obstructive pulmonary disease JO - Int J Chron Obstruct Pulmon Dis VL - 12 N2 - BACKGROUND: Bronchodilators such as long-acting muscarinic antagonists (LAMAs) and long-acting β2-agonists (LABAs) are central to the pharmacological management of COPD. Dual bronchodilation with umeclidinium/vilanterol (UMEC/VI; 62.5/25 μg) is a novel LAMA/LABA combination approved for maintenance treatment for patients with COPD. OBJECTIVE: The objective of this study was to assess the cost-effectiveness of maintenance treatment with UMEC/VI compared with tiotropium (TIO) 18 μg, open dual LAMA + LABA treatment, or no long-acting bronchodilator treatment in patients with moderate to very severe COPD. METHODS: A Markov model was developed to estimate the costs and outcomes associated with UMEC/VI treatment in patients with moderate to very severe COPD (GSK study number: HO-13-13411). Clinical efficacy, costs, utilities, and mortality obtained from the published literature were used as the model inputs. Costs are presented in US dollars based on 2015 prices. The model outputs are total costs, drug costs, other medical costs, number of COPD exacerbations, and quality-adjusted life-years (QALYs). Costs and outcomes were discounted at a 3% annual rate. Incremental cost-effectiveness ratios were calculated. One-way and probabilistic sensitivity analyses were conducted to assess the effects of changing parameters on the uncertainty of the results. RESULTS: UMEC/VI treatment for moderate to very severe COPD was associated with lower lifetime medical costs ($82,344) compared with TIO ($88,822), open dual LAMA + LABA treatment ($114,442), and no long-acting bronchodilator ($86,751). Fewer exacerbations were predicted to occur with UMEC/VI treatment compared with no long-acting bronchodilator treatment. UMEC/VI provided an 0.11 and 0.25 increase in QALYs compared with TIO and no long-acting bronchodilator treatment, and as such, dominated these cost-effectiveness analyses. Sensitivity analyses confirmed that the results were robust. CONCLUSION: The results from this model suggest that UMEC/VI treatment would be dominant compared with TIO and no long-acting bronchodilator treatment, and less costly than open dual LAMA + LABA treatment in patients with moderate to very severe COPD. SN - 1178-2005 UR - https://www.unboundmedicine.com/medline/citation/28392684/Cost_effectiveness_analysis_of_umeclidinium/vilanterol_for_the_management_of_patients_with_moderate_to_very_severe_COPD_using_an_economic_model_ L2 - https://dx.doi.org/10.2147/COPD.S124420 DB - PRIME DP - Unbound Medicine ER -