Trial reportThe European journal of health economics : HEPAC : health economics in prevention and care2007
Modelling the 5-year cost effectiveness of tiotropium, salmeterol and ipratropium for the treatment of chronic obstructive pulmonary disease in Spain.
Trial report in The European journal of health economics : HEPAC : health economics in prevention and care, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 4 syntheses or guidelines pooled it, 84 citations in OpenAlex.
- Long-acting inhaled therapy (beta-agonists, anticholinergics and steroids) for COPD: a network meta-analysis.The Cochrane database of systematic reviews · 2014Pooled it
- Long-acting beta2-agonists for chronic obstructive pulmonary disease.The Cochrane database of systematic reviews · 2013Pooled it
- Tiotropium versus long-acting beta-agonists for stable chronic obstructive pulmonary disease.The Cochrane database of systematic reviews · 2012Pooled it
- Cost effectiveness of pharmacological maintenance treatment for chronic obstructive pulmonary disease: a review of the evidence and methodological issues.PharmacoEconomics · 2012Pooled it
- Respiratory questionnaire-based analysis of awareness of COPD in a large multicenter rural population-based study in India.Chronic diseases and translational medicine · 2022Article
- Estimation of the Clinical and Economic Impact of an Improvement in Adherence Based on the Use of Once-Daily Single-Inhaler Triple Therapy in Patients with COPD.International journal of chronic obstructive pulmonary disease · 2020Article
- Model-based evaluation of the long-term cost-effectiveness of systematic case-finding for COPD in primary care.Thorax · 2019Article
- Cost-Effectiveness of Fixed-Dose Combinations Therapies for Chronic Obstructive Pulmonary Disease Treatment.Clinical drug investigation · 2018Article
- Cost Effectiveness of Support for People Starting a New Medication for a Long-Term Condition Through Community Pharmacies: An Economic Evaluation of the New Medicine Service (NMS) Compared with Normal Practice.PharmacoEconomics · 2017Article
- Cost-effectiveness analysis of umeclidinium/vilanterol for the management of patients with moderate to very severe COPD using an economic model.International journal of chronic obstructive pulmonary disease · 2017Article
- Development of an enhanced health-economic model and cost-effectiveness analysis of tiotropium + olodaterol Respimat® fixed-dose combination for chronic obstructive pulmonary disease patients in Italy.Therapeutic advances in respiratory disease · 2016Article
- Cost-effectiveness of combination therapy umeclidinium/vilanterol versus tiotropium in symptomatic COPD Spanish patients.International journal of chronic obstructive pulmonary disease · 2016Article
- Cost-effectiveness and budget impact of the fixed-dose dual bronchodilator combination tiotropium-olodaterol for patients with COPD in the Netherlands.International journal of chronic obstructive pulmonary disease · 2016Article
- 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.ClinicoEconomics and outcomes research : CEOR · 2016Article
- Patient-reported outcomes and considerations in the management of COPD: focus on aclidinium.Patient preference and adherence · 2015Article
- Cost-effectiveness of tiotropium versus usual care and glycopyrronium in the treatment of chronic obstructive pulmonary disease in Sweden.Cost effectiveness and resource allocation : C/E · 2015Article
- Economic evaluation of aclidinium bromide in the management of moderate to severe COPD: an analysis over 5 years.ClinicoEconomics and outcomes research : CEOR · 2014Article
- A UK-based cost-utility analysis of indacaterol, a once-daily maintenance bronchodilator for patients with COPD, using real world evidence on resource use.Applied health economics and health policy · 2013Article
- Improving clinical reality in chronic obstructive pulmonary disease economic modelling : development and validation of a micro-simulation approach.PharmacoEconomics · 2013Article
- New clinical insights into chronic obstructive pulmonary disease and their implications for pharmacoeconomic analyses.PharmacoEconomics · 2012Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Our objective was to assess the 5-year cost effectiveness of bronchodilator therapy with tiotropium, salmeterol or ipratropium for chronic obstructive pulmonary disease (COPD) from the perspective of the Spanish National Health System (NHS). A probabilistic Markov model was designed wherein patients moved between moderate, severe or very severe COPD and had the risk of exacerbation and death. Probabilities were derived from clinical trials. Spanish healthcare utilisation, costs and utilities were estimated for each COPD and exacerbation state. Outcomes were exacerbations, exacerbation-free months, quality-adjusted life years (QALYs), and cost(-effectiveness). The mean (SE) 5-year number of exacerbations was 3.50 (0.14) for tiotropium, 4.16 (0.40) for salmeterol and 4.71 (0.54) for ipratropium. The mean (SE) number of QALYs was 3.15 (0.08), 3.02 (0.15) and 3.00 (0.20), respectively. Mean (SE) 5-year costs were 6,424 euro (305 euro) for tiotropium, 5,869 euro (505 euro) for salmeterol, and 5,181 euro (682 euro) for ipratropium (2005 values). Ipratropium and tiotropium formed the cost-effectiveness frontier, with tiotropium being preferred when willingness to pay (WTP) exceeded 639 euro per exacerbation-free month and 8,157 euro per QALY. In Spain, tiotropium demonstrated the highest expected net benefit for ratios of the willingness to pay per QALY, well within accepted limits.
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Registered trials
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