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
| 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 |
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| المؤلفون: | Ann-Christin Mörk, Andrew Briggs, Eric D. Bateman, Yevgeniy Samyshkin, R Kotchie |
| المصدر: | The European Journal of Health Economics |
| بيانات النشر: | Springer Berlin Heidelberg, 2013. |
| سنة النشر: | 2013 |
| مصطلحات موضوعية: | Cyclopropanes, Male, Chronic bronchitis, Cost effectiveness, Cost-Benefit Analysis, Economics, Econometrics and Finance (miscellaneous), Aminopyridines, Pulmonary Disease, Chronic Obstructive, I1, Bronchodilator, health care economics and organizations, COPD, Clinical Trials as Topic, Health Policy, Age Factors, Health Services, Middle Aged, I19, Markov Chains, Bronchodilator Agents, Respiratory Function Tests, Benzamides, Bronchitis, Female, Quality-Adjusted Life Years, medicine.drug, medicine.medical_specialty, medicine.drug_class, macromolecular substances, Exacerbations, medicine, Humans, C6, Intensive care medicine, Roflumilast, Aged, Original Paper, business.industry, Cost-effectiveness analysis, medicine.disease, United Kingdom, Quality-adjusted life year, Chronic-obstructive pulmonary disease, Delayed-Action Preparations, Chronic Disease, Phosphodiesterase 4 Inhibitors, business |
| الوصف: | Objective\ud 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.\ud Methods\ud 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.\ud Results\ud 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.\ud Conclusions\ud 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. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 1618-7601 1618-7598 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1e1a9945c5b78606dbf37147bf3df29a http://europepmc.org/articles/PMC3889819 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....1e1a9945c5b78606dbf37147bf3df29a |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 16187601 16187598 |
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