Cost-effectiveness of roflumilast in combination with bronchodilator therapies in patients with severe and very severe COPD in Switzerland
| العنوان: | Cost-effectiveness of roflumilast in combination with bronchodilator therapies in patients with severe and very severe COPD in Switzerland |
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| المؤلفون: | Susan Haefliger, Yevgeniy Samyshkin, Michael Schlunegger, Sabine Ledderhose, Matthew Radford |
| المصدر: | International Journal of COPD, Vol 2013, Iss default, Pp 79-87 (2013) International Journal of Chronic Obstructive Pulmonary Disease |
| بيانات النشر: | Dove Medical Press, 2013. |
| سنة النشر: | 2013 |
| مصطلحات موضوعية: | Cyclopropanes, Male, economic, Cost effectiveness, Cost-Benefit Analysis, Aminopyridines, Severity of Illness Index, Cohort Studies, Pulmonary Disease, Chronic Obstructive, exacerbations, Bronchodilator, health care economics and organizations, Original Research, COPD, treatment, General Medicine, Middle Aged, Markov Chains, Hospitalization, Benzamides, Disease Progression, Drug Therapy, Combination, Female, Quality-Adjusted Life Years, Models, Econometric, Switzerland, Cohort study, medicine.drug, medicine.medical_specialty, medicine.drug_class, Muscarinic Antagonists, Severe copd, International Journal of Chronic Obstructive Pulmonary Disease, Life Expectancy, Severity of illness, medicine, Humans, Intensive care medicine, cost-effectiveness, Adrenergic beta-2 Receptor Agonists, Glucocorticoids, Roflumilast, lcsh:RC705-779, business.industry, modeling, lcsh:Diseases of the respiratory system, medicine.disease, respiratory tract diseases, Quality-adjusted life year, Physical therapy, Phosphodiesterase 4 Inhibitors, business |
| الوصف: | Yevgeniy Samyshkin,1 Michael Schlunegger,2 Susan Haefliger,3 Sabine Ledderhose,3 Matthew Radford11IMS Health, Health Economics and Outcomes Research, London, United Kingdom; 2Marketing Specialty Care, 3Medical Department, Takeda Pharma AG, Pfäffikon, SwitzerlandObjective: Chronic obstructive pulmonary disease (COPD) represents a burden on patients and health systems. Roflumilast, an oral, selective phosphodiesterase-4-inhibitor reduces exacerbations and improves lung function in severe/very severe COPD patients with a history of exacerbations. This study aimed to estimate the lifetime cost and outcomes of roflumilast added-on to commonly used COPD regimens in Switzerland.Methods: A Markov cohort model was developed to simulate COPD progression in patients with disease states of severe, very severe COPD, and death. The exacerbation rate was assumed to be two per year in severe COPD. COPD progression rates were drawn from the published literature. Efficacy was expressed as relative ratios of exacerbation rates associated with roflumilast, derived from a mixed-treatment comparison. A cost-effectiveness analysis was conducted for roflumilast added to long-acting muscarinic antagonists (LAMA), long-acting ß2-agonist/inhaled corticosteroids (LABA/ICS), and LAMA + LABA/ICS. The analysis was conducted from the Swiss payer perspective, with costs and outcomes discounted at 2.5% annually. Parameter uncertainties were explored in one-way and probabilistic sensitivity analyses.Results: In each of the comparator regimens mean life expectancy was 9.28 years and quality-adjusted life years (QALYs) gained were 6.19. Mean estimated lifetime costs per patient in the comparator arms were CHF 83,364 (LAMA), CHF 88,161 (LABA/ICS), and CHF 95,564 (LAMA + LABA/ICS) respectively. Adding roflumilast resulted in a mean cost per patient per lifetime of CHF 86,754 (LAMA + roflumilast), CHF 91,470 (LABA/ICS + roflumilast), and CHF 99,364 (LAMA + LABA/ICS + roflumilast), respectively. Life-expectancy and quality-adjusted life-expectancy were 9.63 years and 6.47 QALYs (LAMA + roflumilast), 9.64 years and 6.48 QALYs (LABA/ICS + roflumilast), and 9.63 years and 6.47 QALYs (LAMA + LABA/ICS + roflumilast). Incremental cost-effectiveness ratios were CHF 12,313, CHF 11,456, and CHF 13,671 per QALY when roflumilast was added to the three regimens.Conclusion: Treatment with roflumilast is estimated to reduce the health and economic burden of COPD exacerbations and represent a cost-effective treatment option for patients with frequent exacerbations in Switzerland.Keywords: COPD, treatment, exacerbations, economic, cost-effectiveness, modeling |
| وصف الملف: | text/html |
| اللغة: | English |
| تدمد: | 1178-2005 1176-9106 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2e1031c73c569ac76d4c66c4d7ee35bdTest http://www.dovepress.com/cost-effectiveness-of-roflumilast-in-combination-with-bronchodilator-t-a12090Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....2e1031c73c569ac76d4c66c4d7ee35bd |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 11782005 11769106 |
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