Cost Effectiveness of the Long-Acting β2-Adrenergic Agonist (LABA)/Long-Acting Muscarinic Antagonist Dual Bronchodilator Indacaterol/Glycopyrronium Versus the LABA/Inhaled Corticosteroid Combination Salmeterol/Fluticasone in Patients with Chronic Obstructive Pulmonary Disease: Analyses Conducted for Canada, France, Italy, and Portugal

M. Reza Maleki-Yazdi; Mathieu Molimard; Dorothy L Keininger; Jean-Bernard Gruenberger; Joao Carrasco; Claudia Pitotti; Elsa Sauvage; Sara  Chehab; David Brendan Price

doi:10.1007/s40258-016-0256-z

Cost Effectiveness of the Long-Acting β2-Adrenergic Agonist (LABA)/Long-Acting Muscarinic Antagonist Dual Bronchodilator Indacaterol/Glycopyrronium Versus the LABA/Inhaled Corticosteroid Combination Salmeterol/Fluticasone in Patients with Chronic Obstructive Pulmonary Disease: Analyses Conducted for Canada, France, Italy, and Portugal

M. Reza Maleki-Yazdi (Corresponding Author), Mathieu Molimard, Dorothy L Keininger, Jean-Bernard Gruenberger, Joao Carrasco, Claudia Pitotti, Elsa Sauvage, Sara Chehab, David Brendan Price

Research output: Contribution to journal › Article › peer-review

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Abstract

Objective The objective of this study was to assess the cost effectiveness of the dual bronchodilator indacaterol/glycopyrronium (IND/GLY) compared with salmeterol/fluticasone combination (SFC) in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) who had a history of one or no exacerbations in the previous year, in Canada, France, Italy, and Portugal. Methods A patient-level simulation was developed to compare the costs and outcomes of IND/GLY versus SFC based on data from the LANTERN trial (NCT01709903). Monte-Carlo simulation methods were employed to follow individual patients over various time horizons. Population and efficacy inputs were derived from the LANTERN trial. Considering the payers’ perspective, only direct costs were included. Costs and health outcomes were discounted annually at 3.0 % for all countries. Unit costs were taken from publically available sources with all costs converted to euros (€). The cost base year was 2015. Deterministic and probabilistic sensitivity analyses were undertaken to test the robustness of the model results. Results IND/GLY was found to be the dominant (more effective and less costly) treatment option compared with SFC in all four countries. The use of IND/GLY was associated with mean total cost savings per patient over a lifetime of €6202, €1974, €1611, and €220 in Canada, France, Italy, and Portugal, respectively. Sensitivity analysis showed that exacerbation rates had the largest impact on incremental costs and quality-adjusted life-years (QALYs). The probability of IND/GLY being cost effective was estimated to be >95 % for thresholds above €5000/QALY. Conclusion In patients with moderate to severe COPD, IND/GLY is likely to be a cost-effective treatment alternative compared with SFC.

Original language	English
Pages (from-to)	579-594
Number of pages	16
Journal	Applied Health Economics and Health Policy
Volume	14
Issue number	5
Early online date	11 Aug 2016
DOIs	https://doi.org/10.1007/s40258-016-0256-z
Publication status	Published - Oct 2016

Bibliographical note

Acknowledgments The authors would like to thank Purnima Pathak
(Novartis) for providing writing assistance in the development of this
manuscript. The authors would also like to thank Colin Burke and
Ronan Mahon (Health Economic Modelers; Novartis) for their
modeling support. Medical writing support was funded by Novartis
Pharma AG (Basel, Switzerland).

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Maleki-Yazdi, M. R., Molimard, M., Keininger, D. L., Gruenberger, J.-B., Carrasco, J., Pitotti, C., Sauvage, E., Chehab, S., & Price, D. B. (2016). Cost Effectiveness of the Long-Acting β2-Adrenergic Agonist (LABA)/Long-Acting Muscarinic Antagonist Dual Bronchodilator Indacaterol/Glycopyrronium Versus the LABA/Inhaled Corticosteroid Combination Salmeterol/Fluticasone in Patients with Chronic Obstructive Pulmonary Disease: Analyses Conducted for Canada, France, Italy, and Portugal. Applied Health Economics and Health Policy, 14(5), 579-594. https://doi.org/10.1007/s40258-016-0256-z

Cost Effectiveness of the Long-Acting β2-Adrenergic Agonist (LABA)/Long-Acting Muscarinic Antagonist Dual Bronchodilator Indacaterol/Glycopyrronium Versus the LABA/Inhaled Corticosteroid Combination Salmeterol/Fluticasone in Patients with Chronic Obstructive Pulmonary Disease: Analyses Conducted for Canada, France, Italy, and Portugal. / Maleki-Yazdi, M. Reza (Corresponding Author); Molimard, Mathieu; Keininger, Dorothy L et al.
In: Applied Health Economics and Health Policy, Vol. 14, No. 5, 10.2016, p. 579-594.

Research output: Contribution to journal › Article › peer-review

Maleki-Yazdi, MR, Molimard, M, Keininger, DL, Gruenberger, J-B, Carrasco, J, Pitotti, C, Sauvage, E, Chehab, S & Price, DB 2016, 'Cost Effectiveness of the Long-Acting β2-Adrenergic Agonist (LABA)/Long-Acting Muscarinic Antagonist Dual Bronchodilator Indacaterol/Glycopyrronium Versus the LABA/Inhaled Corticosteroid Combination Salmeterol/Fluticasone in Patients with Chronic Obstructive Pulmonary Disease: Analyses Conducted for Canada, France, Italy, and Portugal', Applied Health Economics and Health Policy, vol. 14, no. 5, pp. 579-594. https://doi.org/10.1007/s40258-016-0256-z

Maleki-Yazdi MR, Molimard M, Keininger DL, Gruenberger JB, Carrasco J, Pitotti C et al. Cost Effectiveness of the Long-Acting β2-Adrenergic Agonist (LABA)/Long-Acting Muscarinic Antagonist Dual Bronchodilator Indacaterol/Glycopyrronium Versus the LABA/Inhaled Corticosteroid Combination Salmeterol/Fluticasone in Patients with Chronic Obstructive Pulmonary Disease: Analyses Conducted for Canada, France, Italy, and Portugal. Applied Health Economics and Health Policy. 2016 Oct;14(5):579-594. Epub 2016 Aug 11. doi: 10.1007/s40258-016-0256-z

Maleki-Yazdi, M. Reza ; Molimard, Mathieu ; Keininger, Dorothy L et al. / Cost Effectiveness of the Long-Acting β2-Adrenergic Agonist (LABA)/Long-Acting Muscarinic Antagonist Dual Bronchodilator Indacaterol/Glycopyrronium Versus the LABA/Inhaled Corticosteroid Combination Salmeterol/Fluticasone in Patients with Chronic Obstructive Pulmonary Disease : Analyses Conducted for Canada, France, Italy, and Portugal. In: Applied Health Economics and Health Policy. 2016 ; Vol. 14, No. 5. pp. 579-594.

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title = "Cost Effectiveness of the Long-Acting β2-Adrenergic Agonist (LABA)/Long-Acting Muscarinic Antagonist Dual Bronchodilator Indacaterol/Glycopyrronium Versus the LABA/Inhaled Corticosteroid Combination Salmeterol/Fluticasone in Patients with Chronic Obstructive Pulmonary Disease: Analyses Conducted for Canada, France, Italy, and Portugal",

abstract = "Objective The objective of this study was to assess the cost effectiveness of the dual bronchodilator indacaterol/glycopyrronium (IND/GLY) compared with salmeterol/fluticasone combination (SFC) in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) who had a history of one or no exacerbations in the previous year, in Canada, France, Italy, and Portugal. Methods A patient-level simulation was developed to compare the costs and outcomes of IND/GLY versus SFC based on data from the LANTERN trial (NCT01709903). Monte-Carlo simulation methods were employed to follow individual patients over various time horizons. Population and efficacy inputs were derived from the LANTERN trial. Considering the payers{\textquoteright} perspective, only direct costs were included. Costs and health outcomes were discounted annually at 3.0 % for all countries. Unit costs were taken from publically available sources with all costs converted to euros (€). The cost base year was 2015. Deterministic and probabilistic sensitivity analyses were undertaken to test the robustness of the model results. Results IND/GLY was found to be the dominant (more effective and less costly) treatment option compared with SFC in all four countries. The use of IND/GLY was associated with mean total cost savings per patient over a lifetime of €6202, €1974, €1611, and €220 in Canada, France, Italy, and Portugal, respectively. Sensitivity analysis showed that exacerbation rates had the largest impact on incremental costs and quality-adjusted life-years (QALYs). The probability of IND/GLY being cost effective was estimated to be >95 % for thresholds above €5000/QALY. Conclusion In patients with moderate to severe COPD, IND/GLY is likely to be a cost-effective treatment alternative compared with SFC.",

author = "Maleki-Yazdi, {M. Reza} and Mathieu Molimard and Keininger, {Dorothy L} and Jean-Bernard Gruenberger and Joao Carrasco and Claudia Pitotti and Elsa Sauvage and Sara Chehab and Price, {David Brendan}",

note = "Acknowledgments The authors would like to thank Purnima Pathak (Novartis) for providing writing assistance in the development of this manuscript. The authors would also like to thank Colin Burke and Ronan Mahon (Health Economic Modelers; Novartis) for their modeling support. Medical writing support was funded by Novartis Pharma AG (Basel, Switzerland).",

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T1 - Cost Effectiveness of the Long-Acting β2-Adrenergic Agonist (LABA)/Long-Acting Muscarinic Antagonist Dual Bronchodilator Indacaterol/Glycopyrronium Versus the LABA/Inhaled Corticosteroid Combination Salmeterol/Fluticasone in Patients with Chronic Obstructive Pulmonary Disease

T2 - Analyses Conducted for Canada, France, Italy, and Portugal

AU - Maleki-Yazdi, M. Reza

AU - Molimard, Mathieu

AU - Keininger, Dorothy L

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N1 - Acknowledgments The authors would like to thank Purnima Pathak (Novartis) for providing writing assistance in the development of this manuscript. The authors would also like to thank Colin Burke and Ronan Mahon (Health Economic Modelers; Novartis) for their modeling support. Medical writing support was funded by Novartis Pharma AG (Basel, Switzerland).

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N2 - Objective The objective of this study was to assess the cost effectiveness of the dual bronchodilator indacaterol/glycopyrronium (IND/GLY) compared with salmeterol/fluticasone combination (SFC) in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) who had a history of one or no exacerbations in the previous year, in Canada, France, Italy, and Portugal. Methods A patient-level simulation was developed to compare the costs and outcomes of IND/GLY versus SFC based on data from the LANTERN trial (NCT01709903). Monte-Carlo simulation methods were employed to follow individual patients over various time horizons. Population and efficacy inputs were derived from the LANTERN trial. Considering the payers’ perspective, only direct costs were included. Costs and health outcomes were discounted annually at 3.0 % for all countries. Unit costs were taken from publically available sources with all costs converted to euros (€). The cost base year was 2015. Deterministic and probabilistic sensitivity analyses were undertaken to test the robustness of the model results. Results IND/GLY was found to be the dominant (more effective and less costly) treatment option compared with SFC in all four countries. The use of IND/GLY was associated with mean total cost savings per patient over a lifetime of €6202, €1974, €1611, and €220 in Canada, France, Italy, and Portugal, respectively. Sensitivity analysis showed that exacerbation rates had the largest impact on incremental costs and quality-adjusted life-years (QALYs). The probability of IND/GLY being cost effective was estimated to be >95 % for thresholds above €5000/QALY. Conclusion In patients with moderate to severe COPD, IND/GLY is likely to be a cost-effective treatment alternative compared with SFC.

AB - Objective The objective of this study was to assess the cost effectiveness of the dual bronchodilator indacaterol/glycopyrronium (IND/GLY) compared with salmeterol/fluticasone combination (SFC) in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) who had a history of one or no exacerbations in the previous year, in Canada, France, Italy, and Portugal. Methods A patient-level simulation was developed to compare the costs and outcomes of IND/GLY versus SFC based on data from the LANTERN trial (NCT01709903). Monte-Carlo simulation methods were employed to follow individual patients over various time horizons. Population and efficacy inputs were derived from the LANTERN trial. Considering the payers’ perspective, only direct costs were included. Costs and health outcomes were discounted annually at 3.0 % for all countries. Unit costs were taken from publically available sources with all costs converted to euros (€). The cost base year was 2015. Deterministic and probabilistic sensitivity analyses were undertaken to test the robustness of the model results. Results IND/GLY was found to be the dominant (more effective and less costly) treatment option compared with SFC in all four countries. The use of IND/GLY was associated with mean total cost savings per patient over a lifetime of €6202, €1974, €1611, and €220 in Canada, France, Italy, and Portugal, respectively. Sensitivity analysis showed that exacerbation rates had the largest impact on incremental costs and quality-adjusted life-years (QALYs). The probability of IND/GLY being cost effective was estimated to be >95 % for thresholds above €5000/QALY. Conclusion In patients with moderate to severe COPD, IND/GLY is likely to be a cost-effective treatment alternative compared with SFC.

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