Limits...
Cost-effectiveness and budget impact of the fixed-dose dual bronchodilator combination tiotropium – olodaterol for patients with COPD in the Netherlands

View Article: PubMed Central - PubMed

ABSTRACT

Purpose: The fixed-dose dual bronchodilator combination (FDC) of tiotropium and olodaterol showed increased effectiveness regarding lung function and health-related quality of life in patients with chronic obstructive pulmonary disease (COPD) compared with the use of its mono-components. Yet, while effectiveness and safety have been shown, the health economic implication of this treatment is still unknown. The aim of this study was to assess the cost–utility and budget impact of tiotropium–olodaterol FDC in patients with moderate to very severe COPD in the Netherlands.

Patients and methods: A cost–utility study was performed, using an individual-level Markov model. To populate the model, individual patient-level data (age, height, sex, COPD duration, baseline forced expiratory volume in 1 second) were obtained from the tiotropium–olodaterol TOnado trial. In the model, forced expiratory volume in 1 second and patient-level data were extrapolated to utility and survival, and treatment with tiotropium–olodaterol FDC was compared with tiotropium. Cost–utility analysis was performed from the Dutch health care payer’s perspective using a 15-year time horizon in the base-case analysis. The standard Dutch discount rates were applied (costs: 4.0%; effects: 1.5%). Both univariate and probabilistic sensitivity analyses were performed. Budget impact was annually assessed over a 5-year time horizon, taking into account different levels of medication adherence.

Results: As a result of cost increases, combined with quality-adjusted life-year (QALY) gains, results showed that tiotropium–olodaterol FDC had an incremental cost-effectiveness ratio of €7,004/QALY. Without discounting, the incremental cost-effectiveness ratio was €5,981/QALY. Results were robust in univariate and probabilistic sensitivity analyses. Budget impact was estimated at €4.3 million over 5 years assuming 100% medication adherence. Scenarios with 40%, 60%, and 80% adherence resulted in lower 5-year incremental cost increases of €1.7, €2.6, and €3.4 million, respectively.

Conclusion: Tiotropium–olodaterol FDC can be considered a cost-effective treatment under current Dutch cost-effectiveness thresholds.

No MeSH data available.


Related in: MedlinePlus

Total Dutch COPD health care costs with and without tiotropium–olodaterol FDC (in million Euros).Notes: Blue: medication, green: management, orange: exacerbations.Abbreviations: COPD, chronic obstructive pulmonary disease; FDC, fixed-dose dual bronchodilator combination.
© Copyright Policy
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC5036592&req=5

f3-copd-11-2191: Total Dutch COPD health care costs with and without tiotropium–olodaterol FDC (in million Euros).Notes: Blue: medication, green: management, orange: exacerbations.Abbreviations: COPD, chronic obstructive pulmonary disease; FDC, fixed-dose dual bronchodilator combination.

Mentions: In Figure 3, the total yearly national Dutch costs of COPD treatment over a time horizon up to 5 years is presented for a scenario without (left part of each column) and with (right part of each column) tiotropium–olodaterol, assuming 60% medication adherence. Mainly due to expected rise in number of COPD patients, total COPD costs are increasing from €489.1 million without tiotropium–olodaterol (€489.2 with) in 2015 to €663.2 without tiotropium–olodaterol (€664.1 with) million in 2019. As shown, introducing tiotropium–olodaterol will be responsible for less than 1% of the total increase in COPD expenses.


Cost-effectiveness and budget impact of the fixed-dose dual bronchodilator combination tiotropium – olodaterol for patients with COPD in the Netherlands
Total Dutch COPD health care costs with and without tiotropium–olodaterol FDC (in million Euros).Notes: Blue: medication, green: management, orange: exacerbations.Abbreviations: COPD, chronic obstructive pulmonary disease; FDC, fixed-dose dual bronchodilator combination.
© Copyright Policy
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5036592&req=5

f3-copd-11-2191: Total Dutch COPD health care costs with and without tiotropium–olodaterol FDC (in million Euros).Notes: Blue: medication, green: management, orange: exacerbations.Abbreviations: COPD, chronic obstructive pulmonary disease; FDC, fixed-dose dual bronchodilator combination.
Mentions: In Figure 3, the total yearly national Dutch costs of COPD treatment over a time horizon up to 5 years is presented for a scenario without (left part of each column) and with (right part of each column) tiotropium–olodaterol, assuming 60% medication adherence. Mainly due to expected rise in number of COPD patients, total COPD costs are increasing from €489.1 million without tiotropium–olodaterol (€489.2 with) in 2015 to €663.2 without tiotropium–olodaterol (€664.1 with) million in 2019. As shown, introducing tiotropium–olodaterol will be responsible for less than 1% of the total increase in COPD expenses.

View Article: PubMed Central - PubMed

ABSTRACT

Purpose: The fixed-dose dual bronchodilator combination (FDC) of tiotropium and olodaterol showed increased effectiveness regarding lung function and health-related quality of life in patients with chronic obstructive pulmonary disease (COPD) compared with the use of its mono-components. Yet, while effectiveness and safety have been shown, the health economic implication of this treatment is still unknown. The aim of this study was to assess the cost–utility and budget impact of tiotropium–olodaterol FDC in patients with moderate to very severe COPD in the Netherlands.

Patients and methods: A cost–utility study was performed, using an individual-level Markov model. To populate the model, individual patient-level data (age, height, sex, COPD duration, baseline forced expiratory volume in 1 second) were obtained from the tiotropium–olodaterol TOnado trial. In the model, forced expiratory volume in 1 second and patient-level data were extrapolated to utility and survival, and treatment with tiotropium–olodaterol FDC was compared with tiotropium. Cost–utility analysis was performed from the Dutch health care payer’s perspective using a 15-year time horizon in the base-case analysis. The standard Dutch discount rates were applied (costs: 4.0%; effects: 1.5%). Both univariate and probabilistic sensitivity analyses were performed. Budget impact was annually assessed over a 5-year time horizon, taking into account different levels of medication adherence.

Results: As a result of cost increases, combined with quality-adjusted life-year (QALY) gains, results showed that tiotropium–olodaterol FDC had an incremental cost-effectiveness ratio of €7,004/QALY. Without discounting, the incremental cost-effectiveness ratio was €5,981/QALY. Results were robust in univariate and probabilistic sensitivity analyses. Budget impact was estimated at €4.3 million over 5 years assuming 100% medication adherence. Scenarios with 40%, 60%, and 80% adherence resulted in lower 5-year incremental cost increases of €1.7, €2.6, and €3.4 million, respectively.

Conclusion: Tiotropium–olodaterol FDC can be considered a cost-effective treatment under current Dutch cost-effectiveness thresholds.

No MeSH data available.


Related in: MedlinePlus