Cost effectiveness of tiotropium in patients with asthma poorly controlled on inhaled glucocorticosteroids and long-acting β-agonists
| Autor: | Ian D. Pavord, Tania Krivasi, A. Lloyd, Dirk Esser, Eric D. Bateman, Jenny Willson |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Budesonide
Economics and Econometrics medicine.medical_specialty Respiratory Therapy Cost effectiveness Cost-Benefit Analysis Population Scopolamine Derivatives Fluticasone propionate 03 medical and health sciences 0302 clinical medicine Internal medicine Medicine Humans 030212 general & internal medicine Tiotropium Bromide education health care economics and organizations Fluticasone Asthma education.field_of_study business.industry Health Policy General Medicine Adrenergic beta-Agonists medicine.disease Markov Chains Bronchodilator Agents respiratory tract diseases Treatment Outcome 030228 respiratory system Delayed-Action Preparations Salmeterol Quality-Adjusted Life Years business hormones hormone substitutes and hormone antagonists medicine.drug |
| Zdroj: | Applied Health Economics and Health Policy. 12(4) |
| ISSN: | 1179-1896 1175-5652 |
| Popis: | Background: A considerable proportion of patients with asthma remain uncontrolled or symptomatic despite treatment with a high dose of inhaled glucocorticosteroids (ICSs) and long-acting β2-agonists (LABAs). Tiotropium Respimat® added to usual care improves lung function, asthma control, and the frequency of non-severe and severe exacerbations, in a population of adult asthma patients who are uncontrolled despite treatment with ICS/LABA. Objective: This study estimated the cost effectiveness of tiotropium therapy as add-on to usual care in asthma patients that are uncontrolled despite treatment with ICS/LABA combination from the perspective of the UK National Health Service (NHS). Methods: A Markov model was developed which considers levels of asthma control and exacerbations. The model analysed cost and quality-adjusted life-years (QALYs); sensitivity and scenario analyses were also conducted to test the robustness of the base case outcomes. All costs are given at 2012 prices. Results: The model found that in this category of asthma with unmet need, add-on tiotropium therapy generated an incremental 0.24 QALYs and £5,238 costs over a lifetime horizon, resulting in an incremental cost-effectiveness ratio of £21,906 per QALY gained. Sensitivity analysis suggested that findings were most dependent on the costs of managing uncontrolled asthma and the cost of treatment with tiotropium. Conclusion: In this modelled analysis of two clinical trials, tiotropium was found to be cost effective when added to usual care in patients who remain uncontrolled despite treatment with high-dose ICS/LABA. Further research should investigate the long-term treatment effectiveness of tiotropium. © 2014 Springer International Publishing. |
| Databáze: | OpenAIRE |
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