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UK-specific cost-effectiveness of tiotropium + olodaterol fixed-dose combination versus other LAMA + LABA combinations in patients with COPD

Authors Tebboth A, Ternouth A, Gonzalez-Rojas N

Received 5 July 2016

Accepted for publication 30 August 2016

Published 7 November 2016 Volume 2016:8 Pages 667—674

DOI https://doi.org/10.2147/CEOR.S116546

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

Peer reviewer comments 2

Editor who approved publication: Professor Giorgio Lorenzo Colombo

Video abstract presented by Abigail Tebboth.

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Abigail Tebboth,1 Andrew Ternouth,1 Nuria Gonzalez-Rojas2

1Boehringer Ingelheim Ltd., Bracknell, UK; 2Boehringer Ingelheim GmBH, Ingelheim, Germany


Objective: The aim of this study is to assess the cost-effectiveness of other long-acting muscarinic antagonist + long-acting β2 agonist combinations in comparison with Spiolto® Respimat® (tiotropium + olodaterol fixed-dose combination [FDC]) for maintenance treatment to relieve symptoms in adult patients with chronic obstructive pulmonary disease.
Methods: A previously published individual-level Markov model was adapted for the perspective of the UK health care system, in line with recommendations from the National Institute for Health and Care Excellence. Individuals progressed through the model based on their forced expiratory volume in 1 second (FEV1) value at baseline and the post-improvement FEV1 value. Changes in FEV1 were taken from a mixed treatment comparison. Costs were obtained from a published cost-utility analysis of tiotropium in the treatment of chronic obstructive pulmonary disease in the UK. Uncertainty was assessed by deterministic and probabilistic sensitivity analysis.
Results: Duaklir® Genuair® (aclidinium bromide + formoterol fumarate FDC) and the free-dose combination of tiotropium + salmeterol were dominated by tiotropium + olodaterol FDC. The quality-adjusted life years and costs were identical for Ultibro® Breezhaler® (indacaterol + glycopyrronium FDC) and Anoro™ Ellipta® (umeclidinium + vilanterol FDC) compared with tiotropium + olodaterol FDC, resulting in identical incremental cost-effectiveness ratios.
Conclusion: This analysis shows tiotropium + olodaterol FDC to be a cost-effective option for the maintenance treatment of adults with chronic obstructive pulmonary disease in the UK.

Keywords:
COPD, economic, cost-effectiveness, tiotropium + olodaterol

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