Cost-Effectiveness of Long-Acting Bronchodilators for Chronic Obstructive Pulmonary Disease

Oba, Yuji
May 2007
Mayo Clinic Proceedings;May2007, Vol. 82 Issue 5, p575
Academic Journal
OBJECTIVE: To evaluate and compare the cost-effectiveness of long-acting bronchodilators by estimating incremental costs per quality-adjusted life-year (QALY) gained in patients with moderate to severe chronic obstructive pulmonary disease. METHODS: This cost-effective analysis was conducted from a third-party payer's perspective. The study was a retrospective pooled analysis, and the effectiveness evidence was derived from a systematic review of literature published from January 1, 1980, to April 14, 2006. Incremental QALYs were estimated by converting the St George's Respiratory Questionnaire scores into EuroQoL-5D scores and using these combined scores as the summary benefit measure. RESULTS: The incremental cost per additional QALY was $26,094 (range, $11,780-$77,214) for tiotropium and $41,000 (range, $23,650-$98,750) for salmeterol compared with placebo. The cost per QALY gained was lower with tiotropium compared with salmeterol or ipratropium based on either the pooled data of available trials or a head-to-head trial. Treatment with tiotropium could save $391 per year while gaining 13 quality-adjusted days compared with ipratropium. CONCLUSION: Tiotropium appears to be more cost-effective than the alternatives and may be the preferred agent for maintenance therapy in patients with moderate to severe chronic obstructive pulmonary disease. Compared with ipratropium, tiotropium could be cost saving. Because of the wide ranges of cost-effectiveness ratios for tiotropium and salmeterol and the significant overlap between them, a large prospective head-to-head trial would help address the uncertainty and confirm the results of this analysis.


Related Articles

  • Is Combination Therapy with Inhaled Anticholinergics and β2-Adrenoceptor Agonists Justified for Chronic Obstructive Pulmonary Disease? Reddy, Chakravarthy B.; Kanner, Richard E. // Drugs & Aging;2007, Vol. 24 Issue 8, p615 

    Chronic obstructive pulmonary disease (COPD) is a debilitating condition characterised by progressive, irreversible airflow limitation. The economic and social burden of the disease is enormous. The treatment of COPD is guided by the stage of the disease and is aimed primarily at control of...

  • Efficacy of once-daily indacaterol 75 μg relative to alternative bronchodilators in COPD: A study level and a patient level network meta-analysis. Cope, Shannon; Jie Zhang; Williams, James; Jansen, Jeroen P. // BMC Pulmonary Medicine;2012, Vol. 12 Issue 1, p29 

    Background: The objective of this study was to evaluate the comparative efficacy of indacaterol 75 µg once daily (OD), tiotropium 18 µg OD, salmeterol 50 µg twice daily (BID), formoterol 12 µg BID, and placebo for the treatment of chronic obstructive pulmonary disease (COPD) based on...

  • Inhaled corticosteroids are first-line control for asthma. Zablocki, Elaine // Managed Healthcare Executive;Jul2009, Vol. 19 Issue 7, p19 

    The article presents a study which evaluates the effectiveness of inhaled corticosteroids in managing asthma. Result of a study shows that asthmatic patients who spend time with a healthcare professional developing a personalized self- management plan will improved medication compliance and...

  • Theophylline for COPD. Barnes, P. J. // Thorax;Sep2006, Vol. 61 Issue 9, p742 

    The article features theophylline as a bronchodilator in the treatment of chronic obstructive lung disease. The introduction of new drugs resulted to the decrease in the prescription for theophylline. However, as new insights to the molecular action have been discovered, a possibility is seen...

  • Exercise in COPD: damned IF you dc and damned if you don't. Macklem, P. T. // Thorax;Nov2005, Vol. 60 Issue 11, p887 

    The article focuses on the effect of bronchodilators in chronic obstructive pulmonary disease (COPD). In the article, it is found that the patient population separated cleanly into two groups: those whose exercise endurance was improved and those whose exercise endurance decreased. This...

  • tiotropium.  // Davis's Drug Guide for Nurses, 10th edition;2007, p1150 

    This article presents a nurse's guide to the bronchodilator agent tiotropium. Tiotropium is indicated for the long term maintenance treatment of bronchospasm due to chronic obstructive pulmonary disease. Its therapeutics effects include decreased incidence and severity of bronchospasm. It is...

  • A method to study the effect of bronchodilators on smoke retention in COPD patients: study protocol for a randomized controlled trial. van Dijk, W. D.; Scheepers, P. T. J.; Cremers, R.; Lenders, J. W. M.; Klerx, W.; van Weel, C.; Schermer, T. R. J.; Heijdra, Y. // Trials;2011, Vol. 12 Issue 1, p37 

    Background: Chronic obstructive pulmonary disease (COPD) is a common disease, associated with cardiovascular disease. Many patients use (long-acting) bronchodilators, whilst they continue smoking alongside. We hypothesised an interaction between bronchodilators and smoking that...

  • The "Towards a Revolution in COPD Health" study. D'Urzo, Anthony D. // Canadian Family Physician;May2008, Vol. 54 Issue 5, p740 

    The article considers whether salmeterol and fluticasone propionate combination reduces all-cause mortality compared with placebo in patients with chronic obstructive pulmonary disease. According to the author, treatment with salmeterol and fluticasone propionate combination does not...

  • Creatine supplementation during pulmonary rehabilitation in chronic obstructive pulmonary disease. Fuld, J. P.; Kilduff, L. P.; Neder, J. A.; Pitsiladis, Y.; Lean, M. E. J.; Ward, S. A.; Cotton, M. M. // Thorax;Jul2005, Vol. 60 Issue 7, p531 

    Background: Skeletal muscle wasting and dysfunction are strong independent predictors of mortality in patients with chronic obstructive pulmonary disease (COPD). Creatine nutritional supplementation produces increased muscle mass and exercise performance in health. A controlled...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics