scholarly journals Cost-effectiveness analysis of a single-inhaler triple therapy for COPD in the UK

2020 ◽  
pp. 00480-2020
Author(s):  
Elisabeth Fenwick ◽  
Alan Martin ◽  
Melanie Schroeder ◽  
Stuart J. Mealing ◽  
Oyinkansola Solanke ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
United Kingdom ◽  
Cost Effectiveness ◽  
Triple Therapy ◽  
Pulmonary Disease ◽  
Quality Adjusted Life Year ◽  
Chronic Obstructive ◽  
Fluticasone Furoate ◽  
Obstructive Pulmonary Disease ◽  
Quality Adjusted Life

IntroductionUnited Kingdom management costs for chronic obstructive pulmonary disease, estimated at £1.9 billion·year−1, are rising. In the FULFIL (Lung Function and Quality of Life Assessment in Chronic Obstructive Pulmonary Disease with Closed Triple Therapy) study, single-inhaler triple therapy with fluticasone furoate/umeclidinium/vilanterol (100/62.5/25 µg) improved clinical outcomes versus budesonide/formoterol (400/12 µg) in patients with symptomatic chronic obstructive pulmonary disease at risk of exacerbations. We assessed the cost-effectiveness of fluticasone furoate/umeclidinium/vilanterol versus budesonide/formoterol for treating chronic obstructive pulmonary disease from a United Kingdom National Health Service perspective.MethodsA model was developed combining a trial-based and Markov component and populated with baseline and treatment effect data from FULFIL, together with United Kingdom healthcare resource costs and disease-related utilities. Costs per life year and per quality-adjusted life year gained (costing year 2017) for fluticasone furoate/umeclidinium/vilanterol versus budesonide/formoterol were calculated for a lifetime horizon. Results were explored using deterministic sensitivity, scenario and probabilistic analyses.ResultsFluticasone furoate/umeclidinium/vilanterol was associated with gains in life years (0.533) and quality-adjusted life years (0.506) versus budesonide/formoterol, but at slightly increased total costs (£26 416 versus £25 860). This translated to incremental cost-effectiveness ratios of £1042/life year and £1098/quality-adjusted life year for fluticasone furoate/umeclidinium/vilanterol versus budesonide/formoterol. In scenario analyses, incremental cost-effectiveness ratios ranged from dominant to £1547/quality-adjusted life year gained.ConclusionsFluticasone furoate/umeclidinium/vilanterol provides a cost-effective treatment option versus budesonide/formoterol for patients with symptomatic chronic obstructive pulmonary disease in the United Kingdom.

Cost-effectiveness of a telemonitoring program (telEPOC program) in frequently admitted chronic obstructive pulmonary disease patients

2021 ◽  
pp. 1357633X2110372
Author(s):  
Cristóbal Esteban ◽  
Ane Antón ◽  
Javier Moraza ◽  
Milagros Iriberri ◽  
Mateo Larrauri ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Cost Effectiveness ◽  
Pulmonary Disease ◽  
Intervention Group ◽  
Control Group ◽  
Chronic Obstructive ◽  
Cost Effectiveness Ratio ◽  
Obstructive Pulmonary Disease ◽  
The Cost ◽  
Quality Adjusted Life

Chronic obstructive pulmonary disease is a typical disease among chronic and respiratory diseases. The costs associated with chronic disease care are rising dramatically, and this makes it necessary to redesign care processes, including new tools which allow the health system to be more sustainable without compromising on the quality of the care, compared to that currently provided. One approach may be to use information and communication technologies. In this context, we explored the cost-effectiveness of applying a telemonitoring system to a cohort of chronic obstructive pulmonary disease patients with frequent readmissions (the telEPOC programme). We conducted an intervention study with a control group. The inclusion criteria used were having chronic obstructive pulmonary disease (forced expiratory volume in the first second/forced vital capacity  < 70%) and having been hospitalised for exacerbation at least twice in the last year or three times in the last 2 years. We estimated the costs incurred by patients in each group and calculated the quality-adjusted life years and incremental cost-effectiveness ratio. Overall, 77 patients were included in the control group and 86 in the intervention group. The raw cost-effectiveness analysis showed that the cost of the telEPOC intervention was significantly lower than that of usual care, while there were no significant differences between the groups in effectiveness. The incremental cost-effectiveness ratio for the intervention was €175,719.71 per quality-adjusted life-year gained. There were no differences between the intervention group (telemonitoring) and the control group (standard care) from the cost-effectiveness point of view. On the other hand, the intervention programme (telEPOC) was less expensive than routine clinical practice.

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