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Cost-Effectiveness of Glycopyrronium Bromide Compared with Tiotropium in Patients with Chronic Obstructive Pulmonary Disease in Sweden

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Abstract

Objectives

The objective of this study was to compare the cost effectiveness of once-daily Seebri Breezhaler® (glycopyrronium bromide) 50 µg with Spiriva® (tiotropium bromide) 18 µg in the maintenance treatment of chronic obstructive pulmonary disease (COPD) in the Swedish setting.

Methods

A previously published COPD Markov model accounting for disease progression and treatment discontinuation was used. Disease progression included the annual decline in forced expiratory volume in the first second (FEV1) and occurrence of any exacerbations. Efficacy in the model consisted of FEV1 improvement between baseline and 12 weeks and the annual risk ratio of having an exacerbation compared to placebo. These clinical efficacy inputs were derived from a 1-year head-to-head trial comparing glycopyrronium 50 µg to tiotropium 18 µg. Utility values and cost estimates were obtained from the literature. The base-case analysis was performed for a 3-year time horizon. Cost and effects were discounted with 3 % in accordance to Swedish guidelines. Uncertainty was assessed by one-way and probabilistic sensitivity analyses.

Results

Glycopyrronium was found to be less costly and more effective than tiotropium in moderate to severe COPD patients with cost savings of 5197 Swedish kronor (€570, US$725) per patient over a 3-year time horizon. The probabilistic sensitivity analysis indicated that over 99 % of the iterations produced dominant results for glycopyrronium.

Conclusion

Glycopyrronium bromide 50 µg once daily can be considered a cost effective alternative to tiotropium bromide 18 µg once daily in the maintenance treatment of COPD patients in Sweden.

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Notes

  1. Exchange rate from 8 October 2014: SEK1 = €0.109619; SEK1 = US$0.139.

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Author information

Authors and Affiliations

  1. Novartis Pharma AB, Täby, Box 1150, 183 79, Stockholm, Sweden

    Madlaina Costa-Scharplatz

  2. Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden

    Björn Ställberg

  3. Novartis Pharma AG, Basel, Switzerland

    Pankaj Goyal & Jean-Bernard Gruenberger

  4. IMS Health, London, UK

    Yumi Asukai

  5. Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK

    David Price

Authors
  1. Madlaina Costa-Scharplatz
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  2. Björn Ställberg
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  3. Pankaj Goyal
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  4. Yumi Asukai
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  5. Jean-Bernard Gruenberger
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  6. David Price
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Corresponding author

Correspondence to Madlaina Costa-Scharplatz.

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Author contributions

YA and DP developed the original COPD model; MC-S and BS extracted local Swedish input data; YA and MC-S adapted and populated the model with contributions from J-BG, PG, BS and DP; YA, MC-S, PG and J-BG prepared the manuscript and BS and DP provided conceptual and clinical advice.

Funding sources

This study was funded by Novartis Pharma AG.

Conflict of interest

This study and manuscript were sponsored by Novartis which manufacturers Seebri Breezhaler®. MC-S, J-BG and PG are employees of Novartis. YA was an employee of IMS Health who was paid consultants to Novartis. BS has received honoraria for educational activities and lectures from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, MEDA, MSD, Pfizer, Takeda and TEVA, and has served on an advisory board arranged by AstraZeneca, Novartis, GlaxoSmithKline and Boehringer Ingelheim. DP has consultant arrangements and/or has received research grants and/or has spoken for the following companies: Activaero, Aerocrine, Ahnirall, Almirall, AstraZeneca, Boehringer Ingelheim, Chiesi, Cipla, GlaxoSmithKline, Kyorin, Meda, Merck, Mundipharma, Novartis, Napp, Nycomed, Orion, Pfizer, Sandoz, SkyePharma, Teva and the UK National Health Service.

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Costa-Scharplatz, M., Ställberg, B., Goyal, P. et al. Cost-Effectiveness of Glycopyrronium Bromide Compared with Tiotropium in Patients with Chronic Obstructive Pulmonary Disease in Sweden. Appl Health Econ Health Policy 13, 637–645 (2015). https://doi.org/10.1007/s40258-015-0193-2

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  • DOI: https://doi.org/10.1007/s40258-015-0193-2

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