A 1-Year Prospective Cost-Effectiveness Analysis of Roflumilast for the Treatment of Patients with Severe Chronic Obstructive Pulmonary Disease

Mölken, Maureen P.M.H. Rutten-van; Nooten, F.E. van; Lindemann, Marion; Caeser, Manfred; Calverley, Peter M.A.

doi:10.2165/00019053-200725080-00007

Cited by 30 publications

(28 citation statements)

References 39 publications

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“…Interpreting the costs per additional patient with a relevant improvement in SGRQ total score is more difficult, because no reference data are available and, up to now, only one study used this outcome in a CEA [34].…”

Section: Discussionmentioning

confidence: 99%

Is INTERdisciplinary COMmunity-based COPD management (INTERCOM) cost-effective?

Hoogendoorn¹,

Wetering²,

Schols³

et al. 2009

European Respiratory Journal

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The study aimed to estimate the cost-effectiveness of interdisciplinary communitybased chronic obstructive pulmonary disease (COPD) management in patients with COPD.We conducted a cost-effectiveness analysis alongside a 2-yr randomised controlled trial, in which 199 patients with less advanced airflow obstruction and impaired exercise capacity were assigned to the INTERCOM programme or usual care. The INTERCOM programme consisted of exercise training, education, nutritional therapy and smoking cessation counselling offered by community-based physiotherapists and dieticians and hospital-based respiratory nurses. Allcause resource use during 2 yrs was obtained by self-report and from hospital and pharmacy records. Health outcomes were the St George's Respiratory Questionnaire (SGRQ), exacerbations and quality-adjusted life years (QALYs).The INTERCOM group had 30% (95% CI 3-56%) more patients with a clinically relevant improvement in SGRQ total score, 0.08 (95% CI -0.01-0.18) more QALYs per patient, but a higher mean number of exacerbations, 0.84 (95% CI -0.07-1.78). Mean total 2-yr costs were J2,751 (95% CI -J632-J6,372) higher for INTERCOM than for usual care, which resulted in an incremental cost-effectiveness ratio of J9,078 per additional patient with a relevant improvement in SGRQ or J32,425 per QALY.INTERCOM significantly improved disease-specific quality of life, but did not affect exacerbation rate. The cost per QALY ratio was moderate, but within the range of that generally considered to be acceptable.

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Section: Discussionmentioning

confidence: 99%

Is INTERdisciplinary COMmunity-based COPD management (INTERCOM) cost-effective?

Hoogendoorn¹,

Wetering²,

Schols³

et al. 2009

European Respiratory Journal

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“…Secondly, it collected economic data prospectively within the trial, which permits the prospective assessment of value in terms of cost per QALY. Previous analyses of cost-effectiveness alongside clinical trials in COPD have only been able to report results in terms of cost per avoided exacerbation [23,24], which does not facilitate comparisons of results across disease areas (required for reimbursement decisions). QALY number results have previously been presented for COPD treatments, but based on economic modelling studies, which typically project treatment effects from short-term randomised controlled trials over the lifetime of patients [25,26].…”

Section: Discussionmentioning

confidence: 99%

Is treatment with ICS and LABA cost-effective for COPD? Multinational economic analysis of the TORCH study

Briggs

Glick²,

Lozano‐Ortega³

et al. 2009

European Respiratory Journal

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The TOwards a Revolution in COPD Health (TORCH) study was a 3-yr multicentre trial of 6,112 patients randomised to salmeterol (Salm), fluticasone propionate (FP), a Salm/FP combination (SFC) or placebo (P). Here the cost-effectiveness of treatments evaluated in the TORCH study is assessed.For four regions, 3-yr all-cause hospitalisation, medication and outpatient care costs were calculated. The sample was restricted to the 21 countries (n54,237) in which European quality of life five-dimension (EQ-5D) data were collected in order to estimate the number of qualityadjusted life years (QALYs). Regression models were fitted to survival, study medication cost, other medication cost and EQ-5D data in order to estimate total cost, number of QALYs and cost per QALY, adjusted for missing data and region.SFC had a trial-wide estimate of cost per QALY of 43,600 US dollars (USD) compared with P (95% confidence interval 21,400-123,500 USD). Estimates for Salm versus P (197,000 USD) and FP versus P (78,000 USD) were less favourable. The US estimates were greater than those from other regions; for SFC versus P, the cost per QALY was 77,100 (46,700) USD compared to 24,200 (15,200-56,100) USD in Western Europe.Compared with P, SFC has a lower incremental cost-effectiveness ratio than either FP or Salm used alone, and is, therefore, preferred to these monotherapies on the grounds of costeffectiveness.

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“…The rest of the studies did not provide details of the productivity metric used to estimate productivity costs. Only two studies [43,53] explicitly reported using start and end dates for each absence spell. Most of the studies (46 %) that stated how productivity loss was estimated used a questionnaire.…”

Section: Methods Of Estimating Productivity Costs Using the Friction mentioning

confidence: 99%

“…When time was valued by using a wage rate for the value of work time forgone, studies used either a wage rate for the relevant age-sex dependent group (n = 19) or an average wage rate for all groups (n = 18). The exceptions were a weighted-average gross wage rate [43], a median wage rate [29], and the actual wage rate of respondents [36]. Seven studies reported using the age-group gender-based productivity cost per hour from the Dutch Costing Manual [52,54,60,[66][67][68].…”

Section: Methods Of Estimating Productivity Costs Using the Friction mentioning

confidence: 99%

“…Seven studies were set in the United Kingdom [27][28][29][30][31][32][33], two in Germany [34,35], and one in each of the following: Ireland [37], Sweden [38], Canada [21], Spain [39], Denmark [40], Austria [36], Norway [41] and Greece [42] (Table 1). One study, however, was based on a multinational clinical trial setting and used countryspecific costing [43]. In addition, one study conducted economic evaluations in both Austria and the Netherlands [36].…”

Section: Study Characteristicsmentioning

confidence: 99%

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Estimating productivity costs using the friction cost approach in practice: a systematic review

et al. 2014

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Few health economic studies have estimated productivity costs using the friction cost approach. The estimation and reporting of productivity costs using this method appears to differ in quality by country. The review reveals gaps and lack of clarity in reporting of methods for friction cost evaluation. Generating reporting guidelines and country-specific parameters for the friction cost approach is recommended if increased application and accuracy of the method is to be realized.

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A 1-Year Prospective Cost-Effectiveness Analysis of Roflumilast for the Treatment of Patients with Severe Chronic Obstructive Pulmonary Disease

Cited by 30 publications

References 39 publications

Is INTERdisciplinary COMmunity-based COPD management (INTERCOM) cost-effective?

Is INTERdisciplinary COMmunity-based COPD management (INTERCOM) cost-effective?

Is treatment with ICS and LABA cost-effective for COPD? Multinational economic analysis of the TORCH study

Estimating productivity costs using the friction cost approach in practice: a systematic review

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