Cost-Effectiveness of Umeclidinium/Vilanterol versus Salmeterol/Fluticasone in Elderly Patients with Chronic Obstructive Pulmonary Diseases in China.

IF 0.1 4区艺术学 0 ARCHITECTURE DENKMALPFLEGE Pub Date : 2022-03-22 eCollection Date: 2022-01-01 DOI:10.2147/COPD.S350218

Ying Lan, Nan Yang, Yirong Wang, Yujie Yang, Min Xu, Qin He

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Abstract

Background: Fixed dose dual bronchodilators such as long-acting muscarinic antagonists (LAMAs) plus long-acting β2-agonists (LABAs) are a new and important inhaled preparation for COPD treatment in China. Among these, umeclidinium/vilanterol (UMEC/VIL) is increasingly being used in China, especially among the elderly.

Purpose: This study aimed to assess the cost-effectiveness of maintenance treatment with UMEC/VIL compared with salmeterol/fluticasone (FSC) as one of the main therapeutic drugs for moderate to very severe COPD in China.

Methods: A Markov model was developed to estimate the costs and outcomes from a societal perspective in a 10-year time horizon. Patients with moderate-to-very severe COPD were treated with UMEC/VIL (62.5/25µg) or FSC (50/500ug). Data concerning clinical efficacy, costs, utilities, transition probability, exacerbation rate, and mortality were obtained from the published literature and official government datasets. The costs were presented in US dollars based on 2021 prices. The indicators of total costs, life years (LYs), quality-adjusted life-years (QALYs), and mortality were used as the model output. Costs and outcomes were discounted at a 5% annual rate. Incremental cost-effectiveness ratios were calculated considering the threshold recommended by WHO. One-way and probabilistic sensitivity analyses were conducted to assess the stability of results.

Results: Compared with FSC, treatment with UMEC/VIL could save $1947.18, with a gain of 0.12 life-years and 0.05 QALYs. Further, 28.0% patients treated with UMEC/VIL and 29.2% patients treated with FSC were predicted to die after 10 years. Incremental cost effectiveness analysis showed that UMEC/VIL was dominant to FSC. Sensitivity analyses confirmed that the results were robust.

Conclusion: UMEC/VIL is a cost-effective treatment option compared with FSC among patients with moderate-to-very severe COPD.

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中国老年慢性阻塞性肺病患者使用优甲乐/维兰特罗与沙美特罗/氟替卡松的成本效益比较

背景：固定剂量双支气管扩张剂，如长效毒蕈碱类拮抗剂（LAMA）加长效β2-受体激动剂（LABAs），是中国治疗慢性阻塞性肺疾病的一种新的重要吸入制剂。目的：本研究旨在评估与沙美特罗/氟替卡松（FSC）作为中国中度至极重度慢性阻塞性肺疾病的主要治疗药物之一相比，使用 UMEC/VIL 维持治疗的成本效益：方法：我们建立了一个马尔可夫模型，从社会角度估算10年期的成本和疗效。中重度慢性阻塞性肺病患者接受 UMEC/VIL（62.5/25µg）或 FSC（50/500ug）治疗。有关临床疗效、成本、效用、转归概率、恶化率和死亡率的数据均来自公开发表的文献和政府官方数据集。成本以 2021 年的美元价格计算。总成本、生命年（LYs）、质量调整生命年（QALYs）和死亡率指标被用作模型输出。成本和结果按 5%的年贴现率折算。计算增量成本效益比时考虑了世界卫生组织推荐的阈值。为评估结果的稳定性，进行了单向和概率敏感性分析：与 FSC 相比，UMEC/VIL 治疗可节省 1947.18 美元，增加 0.12 个生命年和 0.05 个 QALY。此外，28.0%接受UMEC/VIL治疗的患者和29.2%接受FSC治疗的患者预计将在10年后死亡。增量成本效益分析表明，UMEC/VIL 的疗效优于 FSC。敏感性分析证实结果是可靠的：结论：与 FSC 相比，UMEC/VIL 是中度至极度严重慢性阻塞性肺病患者中一种具有成本效益的治疗方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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