Evidence map›Paper›PMID 29228950›Full record

Trial reportRespiratory research2017

Indacaterol/glycopyrronium is cost-effective compared to salmeterol/fluticasone in COPD: FLAME-based modelling in a Swedish population.

Leif Bjermer, Job F M van Boven, Madlaina Costa-Scharplatz, Dorothy L Keininger, Florian S Gutzwiller, Karin Lisspers, Ronan Mahon, Petter Olsson, Nicolas Roche

Open access · goldAbstract readClinical Trial, Phase IIIComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Respiratory research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.8field-weighted citation impact, top 23% 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

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. Article
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

9 authors at 7 institutions in 5 countries.

Leif BjermerDepartment of Respiratory medicine & Allergology, Skane University Hospital, Lund University, Lund, Sweden.
Job F M van BovenDepartment of General Practice, Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Madlaina Costa-ScharplatzNovartis Sverige AB, Täby, Sweden.
Dorothy L KeiningerNovartis Pharma AG, Basel, Switzerland.
Florian S GutzwillerNovartis Pharma AG, Basel, Switzerland.
Karin LisspersDepartment of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden.
Ronan MahonNovartis Ireland Limited, Dublin, Ireland.
Petter OlssonNovartis Sverige AB, Täby, Sweden.
Nicolas RocheRespiratory and Intensive Care Medicine, Cochin Hospital (AP-HP) and University Paris Descartes, Paris, France. nicolas.roche@aphp.fr.
Novartis (Sweden) · SENovartis (Switzerland) · CHNovartis (Ireland) · IESkåne University Hospital · SEUniversité Paris Cité · FRUniversity of Groningen · NLUppsala University · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study assessed the cost-effectiveness of indacaterol/glycopyrronium (IND/GLY) versus salmeterol/fluticasone (SFC) in chronic obstructive pulmonary disease (COPD) patients with moderate to very severe airflow limitation and ≥1 exacerbation in the preceding year.

methodsA previously published and validated patient-level simulation model was adapted using clinical data from the FLAME trial and real-world cost data from the ARCTIC study. Costs (total monetary costs comprising drug, maintenance, exacerbation, and pneumonia costs) and health outcomes (life-years (LYs), quality-adjusted life-years (QALYs)) were projected over various time horizons (1, 5, 10 years, and lifetime) from the Swedish payer's perspective and were discounted at 3% annually. Uncertainty in model input values was studied through one-way and probabilistic sensitivity analyses. Subgroup analyses were also performed.

resultsIND/GLY was associated with lower costs and better outcomes compared with SFC over all the analysed time horizons. Use of IND/GLY resulted in additional 0.192 LYs and 0.134 QALYs with cost savings of €1211 compared with SFC over lifetime. The net monetary benefit (NMB) was estimated to be €8560 based on a willingness-to-pay threshold of €55,000/QALY. The NMB was higher in the following subgroups: severe (GOLD 3), high risk and more symptoms (GOLD D), females, and current smokers.

conclusionIND/GLY is a cost-effective treatment compared with SFC in COPD patients with mMRC dyspnea grade ≥ 2, moderate to very severe airflow limitation, and ≥1 exacerbation in the preceding year.

Indexed as

Models, EconomicAgedCost-Benefit AnalysisDouble-Blind MethodDrug CombinationsFemaleFluticasone-Salmeterol Drug CombinationGlycopyrrolateHumansIndansMaleMiddle AgedPopulation SurveillancePulmonary Disease, Chronic ObstructiveQuinolonesSwedenDrug CombinationsFluticasone-Salmeterol Drug CombinationGlycopyrrolateindacaterol-glycopyrronium combinationIndansQuinolonesChronic obstructive pulmonary diseaseCost-effectiveExacerbationIndacaterol/glycopyrronium

Identifiers

PMID29228950
PMCPMC5725803
OpenAlexW2773882736

What OpenQuestion holds

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Registered trials

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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.