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Cost-effectiveness analysis of umeclidinium bromide/vilanterol 62.5/25 mcg versus tiotropium/olodaterol 5/5 mcg in symptomatic patients with chronic obstructive pulmonary disease: a Spanish National Healthcare System perspective.
Respir Res. 2018 Nov 20; 19(1):224.RR

Abstract

BACKGROUND

A head-to-head study demonstrated the superiority of once-daily umeclidinium bromide/vilanterol (UMEC/VI) 62.5/25 mcg on trough forced expiratory volume in 1 s (FEV1) versus once-daily tiotropium/olodaterol (TIO/OLO) 5/5 mcg in symptomatic patients with chronic obstructive pulmonary disease (COPD). This analysis evaluated the cost effectiveness of UMEC/VI versus TIO/OLO from a Spanish National Healthcare System perspective, using data from this study and Spanish literature.

METHODS

This analysis was conducted from the perspective of the Spanish National Healthcare System with a 3-year horizon as base case. A disease progression model using a linked risk equation approach was used to estimate disease progression and associated healthcare costs, and quality-adjusted life years (QALYs). The Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study was used to develop the statistical risk equations for clinical endpoints, and costs were calculated using a health state approach (by dyspnea severity). Utilities for QALY calculation were estimated using patient baseline characteristics within a regression fit to Spanish observational data. Treatment effect, expressed as change from baseline in FEV1 was obtained from the head-to-head study and used in the model (UMEC/VI minus TIO/OLO difference: + 52 mL [95% confidence interval: 28, 77]). Baseline patient characteristics were sourced from Spanish literature or the head-to-head study if unavailable. A scenario analysis using only the intent-to-treat (ITT) population from the head-to-head study, and sensitivity analyses (including probabilistic sensitivity analyses), were conducted. Direct healthcare costs (2017 Euro) were obtained from Spanish sources and costs and benefits were discounted at 3% per annum.

RESULTS

UMEC/VI was associated with small improvements in QALYs (+ 0.029) over a 3-year time horizon, compared with TIO/OLO, alongside cost savings of €393/patient. The ITT scenario analysis and sensitivity analyses had similar results. All probabilistic simulations resulted in UMEC/VI being less costly and more effective than TIO/OLO.

CONCLUSION

UMEC/VI dominated TIO/OLO (more effective and less expensive). These results may aid payers and decision-makers in Spain when making judgements on which long-acting muscarinic antagonist/long-acting β2-agonist (LAMA/LABA) treatments can be considered cost effective in Spain.

Authors+Show Affiliations

Value Evidence and Outcomes, GSK, 980 Great West Road, Brentford, Middlesex, TW8 9GS, UK.ICON Health Economics, ICON plc, Abingdon, UK.ICON Health Economics, ICON plc, Abingdon, UK.Departamento de Evaluación de Medicamentos, GSK, Tres Cantos, Madrid, Spain.Global Respiratory Franchise, GSK, Brentford, Middlesex, UK.Value Evidence and Outcomes, GSK, 980 Great West Road, Brentford, Middlesex, TW8 9GS, UK. yumiko.x.asukai@gsk.com.Hospital de Alta Resolución de Loja, Granada, Spain.Pneumology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.Hospital Universitario La Paz-IdiPAZ, Madrid, Spain.ICON Health Economics, ICON, Toronto, ON, Canada.

Pub Type(s)

Journal Article
Observational Study
Randomized Controlled Trial

Language

eng

PubMed ID

30458866

Citation

Driessen, M T., et al. "Cost-effectiveness Analysis of Umeclidinium Bromide/vilanterol 62.5/25 Mcg Versus Tiotropium/olodaterol 5/5 Mcg in Symptomatic Patients With Chronic Obstructive Pulmonary Disease: a Spanish National Healthcare System Perspective." Respiratory Research, vol. 19, no. 1, 2018, p. 224.
Driessen MT, Whalen J, Seewoodharry Buguth B, et al. Cost-effectiveness analysis of umeclidinium bromide/vilanterol 62.5/25 mcg versus tiotropium/olodaterol 5/5 mcg in symptomatic patients with chronic obstructive pulmonary disease: a Spanish National Healthcare System perspective. Respir Res. 2018;19(1):224.
Driessen, M. T., Whalen, J., Seewoodharry Buguth, B., Vallejo-Aparicio, L. A., Naya, I. P., Asukai, Y., Alcázar-Navarrete, B., Miravitlles, M., García-Río, F., & Risebrough, N. A. (2018). Cost-effectiveness analysis of umeclidinium bromide/vilanterol 62.5/25 mcg versus tiotropium/olodaterol 5/5 mcg in symptomatic patients with chronic obstructive pulmonary disease: a Spanish National Healthcare System perspective. Respiratory Research, 19(1), 224. https://doi.org/10.1186/s12931-018-0916-7
Driessen MT, et al. Cost-effectiveness Analysis of Umeclidinium Bromide/vilanterol 62.5/25 Mcg Versus Tiotropium/olodaterol 5/5 Mcg in Symptomatic Patients With Chronic Obstructive Pulmonary Disease: a Spanish National Healthcare System Perspective. Respir Res. 2018 Nov 20;19(1):224. PubMed PMID: 30458866.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-effectiveness analysis of umeclidinium bromide/vilanterol 62.5/25 mcg versus tiotropium/olodaterol 5/5 mcg in symptomatic patients with chronic obstructive pulmonary disease: a Spanish National Healthcare System perspective. AU - Driessen,M T, AU - Whalen,J, AU - Seewoodharry Buguth,B, AU - Vallejo-Aparicio,L A, AU - Naya,I P, AU - Asukai,Y, AU - Alcázar-Navarrete,B, AU - Miravitlles,M, AU - García-Río,F, AU - Risebrough,N A, Y1 - 2018/11/20/ PY - 2018/06/12/received PY - 2018/10/18/accepted PY - 2018/11/22/entrez PY - 2018/11/22/pubmed PY - 2019/2/26/medline KW - Bronchodilators KW - Chronic obstructive pulmonary disease KW - Cost effectiveness KW - Economic evaluation KW - Health resources KW - LAMA/LABA KW - National Healthcare System perspective KW - QALY KW - Spain KW - Utility SP - 224 EP - 224 JF - Respiratory research JO - Respir Res VL - 19 IS - 1 N2 - BACKGROUND: A head-to-head study demonstrated the superiority of once-daily umeclidinium bromide/vilanterol (UMEC/VI) 62.5/25 mcg on trough forced expiratory volume in 1 s (FEV1) versus once-daily tiotropium/olodaterol (TIO/OLO) 5/5 mcg in symptomatic patients with chronic obstructive pulmonary disease (COPD). This analysis evaluated the cost effectiveness of UMEC/VI versus TIO/OLO from a Spanish National Healthcare System perspective, using data from this study and Spanish literature. METHODS: This analysis was conducted from the perspective of the Spanish National Healthcare System with a 3-year horizon as base case. A disease progression model using a linked risk equation approach was used to estimate disease progression and associated healthcare costs, and quality-adjusted life years (QALYs). The Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study was used to develop the statistical risk equations for clinical endpoints, and costs were calculated using a health state approach (by dyspnea severity). Utilities for QALY calculation were estimated using patient baseline characteristics within a regression fit to Spanish observational data. Treatment effect, expressed as change from baseline in FEV1 was obtained from the head-to-head study and used in the model (UMEC/VI minus TIO/OLO difference: + 52 mL [95% confidence interval: 28, 77]). Baseline patient characteristics were sourced from Spanish literature or the head-to-head study if unavailable. A scenario analysis using only the intent-to-treat (ITT) population from the head-to-head study, and sensitivity analyses (including probabilistic sensitivity analyses), were conducted. Direct healthcare costs (2017 Euro) were obtained from Spanish sources and costs and benefits were discounted at 3% per annum. RESULTS: UMEC/VI was associated with small improvements in QALYs (+ 0.029) over a 3-year time horizon, compared with TIO/OLO, alongside cost savings of €393/patient. The ITT scenario analysis and sensitivity analyses had similar results. All probabilistic simulations resulted in UMEC/VI being less costly and more effective than TIO/OLO. CONCLUSION: UMEC/VI dominated TIO/OLO (more effective and less expensive). These results may aid payers and decision-makers in Spain when making judgements on which long-acting muscarinic antagonist/long-acting β2-agonist (LAMA/LABA) treatments can be considered cost effective in Spain. SN - 1465-993X UR - https://www.unboundmedicine.com/medline/citation/30458866/Cost_effectiveness_analysis_of_umeclidinium_bromide/vilanterol_62_5/25_mcg_versus_tiotropium/olodaterol_5/5_mcg_in_symptomatic_patients_with_chronic_obstructive_pulmonary_disease:_a_Spanish_National_Healthcare_System_perspective_ L2 - https://respiratory-research.biomedcentral.com/articles/10.1186/s12931-018-0916-7 DB - PRIME DP - Unbound Medicine ER -