This study assessed the cost-effectiveness of indacaterol/glycopyrronium (IND/GLY) versus salmeterol/fluticasone (SFC) in chronic obstructive pulmonary disease (COPD) patients with moderate to very severe airflow limitation and =1 exacerbation in the preceding year.
A previously published and validated patient-level simulation model was adapted using clinical data from the FLAME trial and real-world cost data from the ARCTIC study. Costs (total monetary costs comprising drug, maintenance, exacerbation, and pneumonia costs) and health outcomes (life-years (LYs), quality-adjusted life-years (QALYs)) were projected over various time horizons (1, 5, 10 years, and lifetime) from the Swedish payer's perspective and were discounted at 3% annually. Uncertainty in model input values was studied through one-way and probabilistic sensitivity analyses. Subgroup analyses were also performed.
IND/GLY was associated with lower costs and better outcomes compared with SFC over all the analysed time horizons. Use of IND/GLY resulted in additional 0.192 LYs and 0.134 QALYs with cost savings of €1211 compared with SFC over lifetime. The net monetary benefit (NMB) was estimated to be €8560 based on a willingness-to-pay threshold of €55,000/QALY. The NMB was higher in the following subgroups: severe (GOLD 3), high risk and more symptoms (GOLD D), females, and current smokers.
IND/GLY is a cost-effective treatment compared with SFC in COPD patients with mMRC dyspnea grade?=?2, moderate to very severe airflow limitation, and =1 exacerbation in the preceding year.
Notes
Cites: Eur Respir J. 2004 Mar;23(3):456-6315065839
Cites: Clin Respir J. 2012 Apr;6(2):120-721651748
Cites: Int J Chron Obstruct Pulmon Dis. 2016 Jan 18;11:123-3226848262
Cites: Int J Chron Obstruct Pulmon Dis. 2016 Sep 19;11:2191-220127703341