| Title |
Cost versus utility of aclidinium bromide 400 μg plus formoterol fumarate dihydrate 12 μg compared to aclidinium bromide 400 μg alone in the management of moderate-to-severe COPD
|
|---|---|
| Published in |
ClinicoEconomics and Outcomes Research: CEOR, September 2016
|
| DOI | 10.2147/ceor.s107121 |
| Pubmed ID | |
| Authors |
Mafalda Ramos, John Haughney, Nathaniel Henry, Leandro Lindner, Mark Lamotte |
| Abstract |
Aclidinium-formoterol 400/12 µg is a long-acting muscarinic antagonist (LAMA) and a long-acting β2-agonist in a fixed-dose combination used in the management of patients with COPD. This study aimed to assess the cost-effectiveness of aclidinium-formoterol 400/12 µg against the long-acting muscarinic antagonist aclidinium bromide 400 µg. A five-health-state Markov transition model with monthly cycles was developed using MS Excel to simulate patients with moderate-to-severe COPD and their initial lung-function improvement following treatment with aclidinium-formoterol 400/12 µg or aclidinium 400 µg. Health states were based on severity levels defined by Global Initiative for Chronic Obstructive Lung Disease 2010 criteria. The analysis was a head-to-head comparison without step-up therapy, from the NHS Scotland perspective, over a 5-year time horizon. Clinical data on initial lung-function improvement were provided by a pooled analysis of the ACLIFORM and AUGMENT trials. Management, event costs, and utilities were health state-specific. Costs and effects were discounted at an annual rate of 3.5%. The outcome of the analysis was expressed as cost (UK£) per quality-adjusted life-year (QALY) gained. The analysis included one way and probabilistic sensitivity analyses to investigate the impact of parameter uncertainty on model outputs. Aclidinium-formoterol 400/12 µg provided marginally higher costs (£41) and more QALYs (0.014), resulting in an incremental cost-effectiveness ratio of £2,976/QALY. Sensitivity analyses indicated that results were robust to key parameter variations, and the main drivers were: mean baseline forced expiratory volume in 1 second (FEV1), risk of exacerbation, FEV1 improvement from aclidinium-formoterol 400/12 µg, and lung-function decline. The probability of aclidinium-formoterol 400/12 µg being cost-effective (using a willingness-to-pay threshold of £20,000/QALY) versus aclidinium 400 µg was 79%. In Scotland, aclidinium-formoterol 400/12 µg can be considered a cost-effective treatment option compared to aclidinium 400 µg alone in patients with moderate-to-severe COPD. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 2 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Practitioners (doctors, other healthcare professionals) | 2 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 29 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 29 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 7 | 24% |
| Researcher | 7 | 24% |
| Student > Bachelor | 4 | 14% |
| Student > Ph. D. Student | 2 | 7% |
| Other | 1 | 3% |
| Other | 3 | 10% |
| Unknown | 5 | 17% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 11 | 38% |
| Pharmacology, Toxicology and Pharmaceutical Science | 3 | 10% |
| Nursing and Health Professions | 3 | 10% |
| Economics, Econometrics and Finance | 2 | 7% |
| Computer Science | 1 | 3% |
| Other | 2 | 7% |
| Unknown | 7 | 24% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 13 September 2016.
All research outputs
#19,944,091
of 25,373,627 outputs
Outputs from ClinicoEconomics and Outcomes Research: CEOR
#399
of 531 outputs
Outputs of similar age
#257,778
of 348,369 outputs
Outputs of similar age from ClinicoEconomics and Outcomes Research: CEOR
#20
of 27 outputs
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