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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.


Budget impact of introducing tiotropium–olodaterol FDC (in million Euros).Abbreviation: FDC, fixed-dose dual bronchodilator combination.
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f4-copd-11-2191: Budget impact of introducing tiotropium–olodaterol FDC (in million Euros).Abbreviation: FDC, fixed-dose dual bronchodilator combination.

Mentions: In Figure 4, the incremental budget impact of introducing tiotropium–olodaterol FDC over a time horizon of 5 years is presented. Due to expected rise in number of COPD patients and increased market share projections (ranging from 0.6% of COPD patients that require long-acting bronchodilators on tiotropium–olodaterol in year 1 to 7.7% in year 5, see Table S4), incremental costs are increasing from €55,288 in 2015 to €877,641 in 2019 (summing up to €2.6 million over 5 years).


Cost-effectiveness and budget impact of the fixed-dose dual bronchodilator combination tiotropium – olodaterol for patients with COPD in the Netherlands
Budget impact of introducing tiotropium–olodaterol FDC (in million Euros).Abbreviation: FDC, fixed-dose dual bronchodilator combination.
© Copyright Policy
Related In: Results  -  Collection

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

f4-copd-11-2191: Budget impact of introducing tiotropium–olodaterol FDC (in million Euros).Abbreviation: FDC, fixed-dose dual bronchodilator combination.
Mentions: In Figure 4, the incremental budget impact of introducing tiotropium–olodaterol FDC over a time horizon of 5 years is presented. Due to expected rise in number of COPD patients and increased market share projections (ranging from 0.6% of COPD patients that require long-acting bronchodilators on tiotropium–olodaterol in year 1 to 7.7% in year 5, see Table S4), incremental costs are increasing from €55,288 in 2015 to €877,641 in 2019 (summing up to €2.6 million over 5 years).

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.