Evidence map›Paper›PMID 27703341›Full record

ArticleInternational journal of chronic obstructive pulmonary disease2016

Cost-effectiveness and budget impact of the fixed-dose dual bronchodilator combination tiotropium-olodaterol for patients with COPD in the Netherlands.

Job Fm van Boven, Janwillem Wh Kocks, Maarten J Postma

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of chronic obstructive pulmonary disease, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 12% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.

  1. Pooled it
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  11. Inhaled therapies in patients with moderate COPD in clinical practice: current thinking.International journal of chronic obstructive pulmonary disease · 2018
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 4 countries.

Job Fm van BovenDepartment of Pharmacy, Unit of PharmacoEpidemiology & PharmacoEconomics; Department of General Practice, Groningen Research Institute for Asthma and COPD (GRIAC).
Janwillem Wh KocksDepartment of General Practice, Groningen Research Institute for Asthma and COPD (GRIAC).
Maarten J PostmaDepartment of Pharmacy, Unit of PharmacoEpidemiology & PharmacoEconomics; Institute of Science in Healthy Aging & healthcaRE (SHARE); Department of Epidemiology, University Medical Center Groningen (UMCG), University of Groningen, Groningen, the Netherlands.
Institute for Asthma and Allergy · USScience Health Allied Research Education · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe fixed-dose dual bronchodilator combination (FDC) of tiotropium and olodaterol showed increased effectiveness regarding lung function and health-related quality of life in patients with chronic obstructive pulmonary disease (COPD) compared with the use of its mono-components. Yet, while effectiveness and safety have been shown, the health economic implication of this treatment is still unknown. The aim of this study was to assess the cost-utility and budget impact of tiotropium-olodaterol FDC in patients with moderate to very severe COPD in the Netherlands. PATIENTS AND

methodsA cost-utility study was performed, using an individual-level Markov model. To populate the model, individual patient-level data (age, height, sex, COPD duration, baseline forced expiratory volume in 1 second) were obtained from the tiotropium-olodaterol TOnado trial. In the model, forced expiratory volume in 1 second and patient-level data were extrapolated to utility and survival, and treatment with tiotropium-olodaterol FDC was compared with tiotropium. Cost-utility analysis was performed from the Dutch health care payer's perspective using a 15-year time horizon in the base-case analysis. The standard Dutch discount rates were applied (costs: 4.0%; effects: 1.5%). Both univariate and probabilistic sensitivity analyses were performed. Budget impact was annually assessed over a 5-year time horizon, taking into account different levels of medication adherence.

resultsAs a result of cost increases, combined with quality-adjusted life-year (QALY) gains, results showed that tiotropium-olodaterol FDC had an incremental cost-effectiveness ratio of €7,004/QALY. Without discounting, the incremental cost-effectiveness ratio was €5,981/QALY. Results were robust in univariate and probabilistic sensitivity analyses. Budget impact was estimated at €4.3 million over 5 years assuming 100% medication adherence. Scenarios with 40%, 60%, and 80% adherence resulted in lower 5-year incremental cost increases of €1.7, €2.6, and €3.4 million, respectively.

conclusionTiotropium-olodaterol FDC can be considered a cost-effective treatment under current Dutch cost-effectiveness thresholds.

Indexed as

BudgetsDrug CostsAdrenergic beta-2 Receptor AgonistsAgedBenzoxazinesBronchodilator AgentsCholinergic AntagonistsCost-Benefit AnalysisDisease ProgressionDrug CombinationsFemaleForced Expiratory VolumeHumansLungMaleMarkov ChainsAdrenergic beta-2 Receptor AgonistsBenzoxazinesBronchodilator AgentsCholinergic AntagonistsDrug CombinationsTiotropium Bromidetiotropium-olodaterolbudget impactCOPDcost-effectivenesscost–utilityhealth economics

Identifiers

PMID27703341
PMCPMC5036592
OpenAlexW2522108195

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.