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

In patients with moderate to severe COPD, IND/GLY is likely to be a cost-effective treatment alternative compared with SFC.

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

“…Figure 1 shows the structure of the model. In-depth model mechanics and validation have been previously published and the model has been used in an earlier assessment of dual bronchodilation by IND/GLY [ 12 – 14 ]. This model was adapted to the Swedish setting using exacerbation and maintenance costs from the ARCTIC study, a large, real-world retrospective Swedish cohort study of 18,586 eligible primary care COPD patients [ 16 – 18 ].…”

“…Because COPD carries a significant health and economic burden, available therapies should be critically evaluated for their costs and benefits when making treatment decisions. Indeed, two previously conducted cost-effectiveness analyses (CEAs) have shown favourable cost-effectiveness of IND/GLY compared with SFC in patients with moderate-to-severe COPD and a history of one or no exacerbation in the previous year [ 12 , 13 ]. Given changing drug treatment costs and the growing role of LABA/LAMAs in the GOLD 2017 strategy new economic evaluations are needed.…”

Cost-effectiveness of indacaterol/glycopyrronium in comparison with salmeterol/fluticasone combination for patients with moderate-to-severe chronic obstructive pulmonary disease: a LANTERN population analysis from Singapore

“…Further, a recently published cost-effectiveness analysis based on the LANTERN data reported that IND/GLY was more effective and less costly than SFC for patients with a history of ≤ 1 exacerbation in the previous year in four healthcare settings, namely Canada, France, Italy and Portugal. (47) In conclusion, this study suggests that IND/GLY is costeffective when compared to SFC for patients with no exacerbation or those at low risk of exacerbation, similar to the patient population assessed in the LANTERN study, over the lifetime horizon in the Singapore healthcare setting. With the use of IND/GLY over SFC, health benefits were observed in terms of QALYs and LYs and there were cost savings in terms of drug, maintenance, exacerbation and pneumonia costs.…”

<p>Modelling the Cost-Effectiveness of Indacaterol/Glycopyrronium versus Salmeterol/Fluticasone Using a Novel Markov Exacerbation-Based Approach</p>

“…To address this limitation, patient-level (or micro) simulation models have been developed, which consider a much broader range of clinical events and complications, such as exacerbations, symptom worsening, pneumonia and changes in health-related quality of life (HRQoL). [16][17][18][19][20] Such models include a recent patient-level simulation model that included 14 patient characterstics, seven intermediate outcomes (eg lung function, exacerbations, and pnemonias) and three final outcomes (mortality, qualityadjusted life years [QALYs] and costs), which allowed for evaluation of the effect of treatment for various subgroups of COPD patients. 21 Indacaterol/glycopyrronium (IND/GLY) was the first LABA/LAMA combination to be approved for the treatment of COPD and consequently, its cost-effectiveness has been studied extensively, [16][17][18][19]22,23 including via microsimulation modelling.…”

“…[16][17][18][19][20] Such models include a recent patient-level simulation model that included 14 patient characterstics, seven intermediate outcomes (eg lung function, exacerbations, and pnemonias) and three final outcomes (mortality, qualityadjusted life years [QALYs] and costs), which allowed for evaluation of the effect of treatment for various subgroups of COPD patients. 21 Indacaterol/glycopyrronium (IND/GLY) was the first LABA/LAMA combination to be approved for the treatment of COPD and consequently, its cost-effectiveness has been studied extensively, [16][17][18][19]22,23 including via microsimulation modelling. 18,20 In the microsimulation model, 20 IND/GLY was shown to be cost-effective compared with the LABA/ inhaled corticosteroid (ICS) combination salmeterol/fluticasone (SFC) in patients at risk of exacerbations.…”