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

A Briggs; H Glick; G Lozano-Ortega; M Spencer; P Calverley; P Jones; J Vestbo; NN NN

doi:10.1183/09031936.00153108

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

A Briggs, H Glick, G Lozano-Ortega, M Spencer, P Calverley, P Jones, J Vestbo, NN NN

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

56 Citationer (Scopus)

Abstract

Udgivelsesdato: 2010-Mar

Originalsprog	Engelsk
Tidsskrift	European Respiratory Journal
Vol/bind	35
Udgave nummer	3
Sider (fra-til)	532-9
ISSN	0903-1936
DOI	https://doi.org/10.1183/09031936.00153108 https://doi.org/10.1183/09031936.00153108
Status	Udgivet - 2009

Bibliografisk note

Keywords: Administration, Inhalation; Adrenal Cortex Hormones; Aged; Albuterol; Androstadienes; Bronchodilator Agents; Cost-Benefit Analysis; Drug Combinations; Female; Humans; Male; Middle Aged; Pulmonary Disease, Chronic Obstructive; Quality-Adjusted Life Years

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Citationsformater

@article{18aca830aac211df928f000ea68e967b,

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

abstract = "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 (n = 4,237) in which European quality of life five-dimension (EQ-5D) data were collected in order to estimate the number of quality-adjusted 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 (46,200-241,700) 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 cost-effectiveness.",

author = "A Briggs and H Glick and G Lozano-Ortega and M Spencer and P Calverley and P Jones and J Vestbo and NN NN",

note = "Keywords: Administration, Inhalation; Adrenal Cortex Hormones; Aged; Albuterol; Androstadienes; Bronchodilator Agents; Cost-Benefit Analysis; Drug Combinations; Female; Humans; Male; Middle Aged; Pulmonary Disease, Chronic Obstructive; Quality-Adjusted Life Years",

year = "2009",

doi = "10.1183/09031936.00153108",

language = "English",

volume = "35",

pages = "532--9",

journal = "The European Respiratory Journal",

issn = "0903-1936",

publisher = "European Respiratory Society",

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TY - JOUR

T1 - Is treatment with ICS and LABA cost-effective for COPD? Multinational economic analysis of the TORCH study

AU - Briggs, A

AU - Glick, H

AU - Lozano-Ortega, G

AU - Spencer, M

AU - Calverley, P

AU - Jones, P

AU - Vestbo, J

AU - NN, NN

N1 - Keywords: Administration, Inhalation; Adrenal Cortex Hormones; Aged; Albuterol; Androstadienes; Bronchodilator Agents; Cost-Benefit Analysis; Drug Combinations; Female; Humans; Male; Middle Aged; Pulmonary Disease, Chronic Obstructive; Quality-Adjusted Life Years

PY - 2009

Y1 - 2009

N2 - 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 (n = 4,237) in which European quality of life five-dimension (EQ-5D) data were collected in order to estimate the number of quality-adjusted 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 (46,200-241,700) 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 cost-effectiveness.

AB - 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 (n = 4,237) in which European quality of life five-dimension (EQ-5D) data were collected in order to estimate the number of quality-adjusted 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 (46,200-241,700) 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 cost-effectiveness.

U2 - 10.1183/09031936.00153108

DO - 10.1183/09031936.00153108

M3 - Journal article

C2 - 19717476

VL - 35

SP - 532

EP - 539

JO - The European Respiratory Journal

JF - The European Respiratory Journal

SN - 0903-1936

IS - 3

ER -