Details
| Original language | English |
|---|---|
| Pages (from-to) | 556-564 |
| Number of pages | 9 |
| Journal | European Respiratory Journal |
| Volume | 41 |
| Issue number | 3 |
| Early online date | 14 Jun 2012 |
| Publication status | Published - 28 Feb 2013 |
Abstract
The aim of this study was to perform a 1-yr trial-based cost-effectiveness analysis (CEA) of tiotropium versus salmeterol followed by a 5-yr model-based CEA. The within-trial CEA, including 7,250 patients with moderate to very severe chronic obstructive pulmonary disease (COPD), was performed alongside the 1-yr international randomised controlled Prevention of Exacerbations with Tiotropium (POET)-COPD trial comparing tiotropium with salmeterol regarding the effect on exacerbations. Main end-points of the trial-based analysis were costs, number of exacerbations and exacerbation days. The model-based analysis was conducted to extrapolate results to 5 yrs and to calculate quality-adjusted life years (QALYs). 1-yr costs per patient from the German statutory health insurance (SHI) perspective and the societal perspective were J126 (95% uncertainty interval (UI) J55-195) and J170 (95% UI J77- 260) higher for tiotropium, respectively. The annual number of exacerbations was 0.064 (95% UI 0.010-0.118) lower for tiotropium, leading to a reduction in exacerbation-related costs of J87 (95% UI J19-157). The incremental cost-effectiveness ratio was J1,961 per exacerbation avoided from the SHI perspective and J2,647 from the societal perspective. In the model-based analyses, the 5-yr costs per QALY were J3,488 from the SHI perspective and J8,141 from the societal perspective. Tiotropium reduced exacerbations and exacerbation-related costs, but increased total costs. Tiotropium can be considered cost-effective as the resulting cost-effectiveness ratios were below commonly accepted willingness-to-pay thresholds.
Keywords
- Chronic obstructive pulmonary disease, Costs, Exacerbations, Model, Qualityadjusted life year, Trial
ASJC Scopus subject areas
- Medicine(all)
- Pulmonary and Respiratory Medicine
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In: European Respiratory Journal, Vol. 41, No. 3, 28.02.2013, p. 556-564.
Research output: Contribution to journal › Article › Research › peer review
}
TY - JOUR
T1 - Cost-effectiveness of tiotropium versus salmeterol
T2 - the POET-COPD trial
AU - Hoogendoorn, Martine
AU - Al, Maiwenn J.
AU - Beeh, Kai Michael
AU - Bowles, David
AU - Von Der Schulenburg, J. Matthias Graf
AU - Lungershausen, Juliane
AU - Monz, Brigitta U.
AU - Schmidt, Hendrik
AU - Vogelmeier, Claus
AU - Mölken, Maureen P.M.H.Rutten Van
PY - 2013/2/28
Y1 - 2013/2/28
N2 - The aim of this study was to perform a 1-yr trial-based cost-effectiveness analysis (CEA) of tiotropium versus salmeterol followed by a 5-yr model-based CEA. The within-trial CEA, including 7,250 patients with moderate to very severe chronic obstructive pulmonary disease (COPD), was performed alongside the 1-yr international randomised controlled Prevention of Exacerbations with Tiotropium (POET)-COPD trial comparing tiotropium with salmeterol regarding the effect on exacerbations. Main end-points of the trial-based analysis were costs, number of exacerbations and exacerbation days. The model-based analysis was conducted to extrapolate results to 5 yrs and to calculate quality-adjusted life years (QALYs). 1-yr costs per patient from the German statutory health insurance (SHI) perspective and the societal perspective were J126 (95% uncertainty interval (UI) J55-195) and J170 (95% UI J77- 260) higher for tiotropium, respectively. The annual number of exacerbations was 0.064 (95% UI 0.010-0.118) lower for tiotropium, leading to a reduction in exacerbation-related costs of J87 (95% UI J19-157). The incremental cost-effectiveness ratio was J1,961 per exacerbation avoided from the SHI perspective and J2,647 from the societal perspective. In the model-based analyses, the 5-yr costs per QALY were J3,488 from the SHI perspective and J8,141 from the societal perspective. Tiotropium reduced exacerbations and exacerbation-related costs, but increased total costs. Tiotropium can be considered cost-effective as the resulting cost-effectiveness ratios were below commonly accepted willingness-to-pay thresholds.
AB - The aim of this study was to perform a 1-yr trial-based cost-effectiveness analysis (CEA) of tiotropium versus salmeterol followed by a 5-yr model-based CEA. The within-trial CEA, including 7,250 patients with moderate to very severe chronic obstructive pulmonary disease (COPD), was performed alongside the 1-yr international randomised controlled Prevention of Exacerbations with Tiotropium (POET)-COPD trial comparing tiotropium with salmeterol regarding the effect on exacerbations. Main end-points of the trial-based analysis were costs, number of exacerbations and exacerbation days. The model-based analysis was conducted to extrapolate results to 5 yrs and to calculate quality-adjusted life years (QALYs). 1-yr costs per patient from the German statutory health insurance (SHI) perspective and the societal perspective were J126 (95% uncertainty interval (UI) J55-195) and J170 (95% UI J77- 260) higher for tiotropium, respectively. The annual number of exacerbations was 0.064 (95% UI 0.010-0.118) lower for tiotropium, leading to a reduction in exacerbation-related costs of J87 (95% UI J19-157). The incremental cost-effectiveness ratio was J1,961 per exacerbation avoided from the SHI perspective and J2,647 from the societal perspective. In the model-based analyses, the 5-yr costs per QALY were J3,488 from the SHI perspective and J8,141 from the societal perspective. Tiotropium reduced exacerbations and exacerbation-related costs, but increased total costs. Tiotropium can be considered cost-effective as the resulting cost-effectiveness ratios were below commonly accepted willingness-to-pay thresholds.
KW - Chronic obstructive pulmonary disease
KW - Costs
KW - Exacerbations
KW - Model
KW - Qualityadjusted life year
KW - Trial
UR - http://www.scopus.com/inward/record.url?scp=84875246141&partnerID=8YFLogxK
U2 - 10.1183/09031936.00027212
DO - 10.1183/09031936.00027212
M3 - Article
C2 - 22700844
AN - SCOPUS:84875246141
VL - 41
SP - 556
EP - 564
JO - European Respiratory Journal
JF - European Respiratory Journal
SN - 0903-1936
IS - 3
ER -