Indacaterol/glycopyrronium is cost-effective compared to salmeterol/fluticasone in COPD: FLAME-based modelling in a Swedish population

Research output: Contribution to journalArticle

Bibtex

@article{2f274ec7ef2d4584baf2f5cf005750b5,
title = "Indacaterol/glycopyrronium is cost-effective compared to salmeterol/fluticasone in COPD: FLAME-based modelling in a Swedish population",
abstract = "Background: 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. Methods: 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. Results: 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. Conclusion: 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.",
keywords = "Chronic obstructive pulmonary disease, Cost-effective, Exacerbation, Indacaterol/glycopyrronium",
author = "Leif Bjermer and {van Boven}, {Job F.M.} and Madlaina Costa-Scharplatz and Keininger, {Dorothy L.} and Gutzwiller, {Florian S.} and Karin Lisspers and Ronan Mahon and Petter Olsson and Nicolas Roche",
year = "2017",
month = dec,
day = "11",
doi = "10.1186/s12931-017-0688-5",
language = "English",
volume = "18",
journal = "Respiratory Research",
issn = "1465-9921",
publisher = "BioMed Central (BMC)",
number = "1",

}