دورية أكاديمية
أعرض في EDS

Cost-effectiveness of roflumilast as an add-on treatment to long-acting bronchodilators in the treatment of COPD associated with chronic bronchitis in the United Kingdom.

التفاصيل البيبلوغرافية
العنوان: Cost-effectiveness of roflumilast as an add-on treatment to long-acting bronchodilators in the treatment of COPD associated with chronic bronchitis in the United Kingdom.
المؤلفون: Samyshkin Y; IMS Health, 210 Pentonville Road, London, N1 9JY, UK, ysamyshkin@uk.imshealth.com., Kotchie RW, Mörk AC, Briggs AH, Bateman ED
المصدر: The European journal of health economics : HEPAC : health economics in prevention and care [Eur J Health Econ] 2014 Jan; Vol. 15 (1), pp. 69-82. Date of Electronic Publication: 2013 Feb 08.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Springer-Verlag Country of Publication: Germany NLM ID: 101134867 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1618-7601 (Electronic) Linking ISSN: 16187598 NLM ISO Abbreviation: Eur J Health Econ Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Berlin : Springer-Verlag, c2001-
مواضيع طبية MeSH: Aminopyridines/*economics , Aminopyridines/*therapeutic use , Benzamides/*economics , Benzamides/*therapeutic use , Bronchodilator Agents/*therapeutic use , Phosphodiesterase 4 Inhibitors/*economics , Phosphodiesterase 4 Inhibitors/*therapeutic use , Pulmonary Disease, Chronic Obstructive/*drug therapy, Age Factors ; Aged ; Aminopyridines/administration & dosage ; Benzamides/administration & dosage ; Bronchitis/epidemiology ; Bronchodilator Agents/administration & dosage ; Chronic Disease ; Clinical Trials as Topic ; Cost-Benefit Analysis ; Cyclopropanes/administration & dosage ; Cyclopropanes/economics ; Cyclopropanes/therapeutic use ; Delayed-Action Preparations ; Female ; Health Services/economics ; Health Services/statistics & numerical data ; Humans ; Male ; Markov Chains ; Middle Aged ; Phosphodiesterase 4 Inhibitors/administration & dosage ; Pulmonary Disease, Chronic Obstructive/epidemiology ; Quality-Adjusted Life Years ; Respiratory Function Tests ; United Kingdom
مستخلص: Objective: To estimate the cost-effectiveness of adding a selective phosphodiesterase-4 inhibitor, roflumilast, to a long-acting bronchodilator therapy (LABA) for the treatment of patients with severe-to-very severe chronic obstructive pulmonary disease (COPD) associated with chronic bronchitis with a history of frequent exacerbations from the UK payer perspective.
Methods: A Markov model was developed to predict the lifetime cost and outcomes [exacerbations rates, life expectancy, and quality-adjusted life years (QALY)] in patients treated with roflumilast, which showed a reduction in the exacerbation rates and lung function improvement in a pooled analysis from two clinical trials, M2-124 and M2-125. Sensitivity analyses were conducted to explore the impact of uncertainties on the cost-effectiveness.
Results: The addition of roflumilast to concomitant LABA reduced the number of exacerbations from 15.6 to 12.7 [2.9 (95 % CI 0.88-4.92) exacerbations avoided] and increased QALYs from 5.45 to 5.61 [0.16 (95 % CI 0.02-0.31) QALYs gained], at an incremental cost of £3,197 (95 % CI £2,135-£4,253). Cost in LABA alone and LABA + roflumilast were £16,161 and £19,358 respectively. The incremental cost-effectiveness ratios in the base case were £19,505 (95 % CI £364-£38,646) per quality-adjusted life-year gained and 18,219 (95 % CI £12,697-£49,135) per life-year gained. Sensitivity analyses suggest that among the main determinants of cost-effectiveness are the reduction of exacerbations and the case fatality rate due to hospital-treated exacerbations. Probabilistic sensitivity analysis suggests that the probability of roflumilast being cost-effective is 82 % at willingness-to-pay £30,000 per QALY.
Conclusions: The addition of roflumilast to LABA in the treatment of patients with severe-to-very severe COPD reduces the rate of exacerbations and can be cost-effective in the UK setting.
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المشرفين على المادة: 0 (Aminopyridines)
0 (Benzamides)
0 (Bronchodilator Agents)
0 (Cyclopropanes)
0 (Delayed-Action Preparations)
0 (Phosphodiesterase 4 Inhibitors)
0P6C6ZOP5U (Roflumilast)
تواريخ الأحداث: Date Created: 20130209 Date Completed: 20140922 Latest Revision: 20211021
رمز التحديث: 20240513
مُعرف محوري في PubMed: PMC3889819
DOI: 10.1007/s10198-013-0456-5
PMID: 23392624
قاعدة البيانات: MEDLINE
الوصف
تدمد:1618-7601
DOI:10.1007/s10198-013-0456-5