Abstract
Aims:
This study presents a cost-effectiveness and budget impact analysis comparing cost and outcomes for UK patients with COPD treated with either tiotropium, ipratropium or salmeterol.
Methods:
A previously-published COPD cost-effectiveness model was adapted for the UK, then used to estimate the cost-effectiveness of tiotropium compared to salmeterol and ipratropium. Additional epidemiological data were used to estimate the budget impact of switching patients from ipratropium or salmeterol to tiotropium.
Results:
In England, the estimated annual cost per patient on tiotropium was £1350, on salmeterol was £1404, and on ipratropium was £1427; in Scotland/Wales/Northern Ireland (S/W/NI) these costs were £1439, £1565, and £1631, respectively. Tiotropium patients experienced better quality-adjusted life-years (QALYs) across all comparisons, and this option was therefore dominant compared to salmeterol and ipratropium. The probability of tiotropium being dominant ranged from 72% to 87% across comparisons. At a willingness-to-pay threshold of £20,000 per QALY, tiotropium had at least a 97% chance of being cost-effective. The estimated annual saving per primary care trust (PCT) of switching patients from salmeterol and ipratropium to tiotropium in England was £230,000 and in S/W/NI was £160,000.
Conclusions:
Tiotropium is a cost-effective alternative to ipratropium and salmeterol, and switching COPD patients from ipratropium and salmeterol to tiotropium could result in considerable cost savings for PCTs along with improvements in quality-of-life.
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Jane Griffin and Ray Gani are employees of Boehringer Ingelheim who manufacture and co-promote tiotropium. Steve Kelly is an employee of Pfizer who co-promote tiotropium. Maureen Rutten-van Mölken is a consultant who has received fees for work carried out for Boehringer Ingelheim and Pfizer.
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Gani, R., Griffin, J., Kelly, S. et al. Economic analyses comparing tiotropium with ipratropium or salmeterol in UK patients with COPD. Prim Care Respir J 19, 68–74 (2010). https://doi.org/10.4104/pcrj.2010.00001
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DOI: https://doi.org/10.4104/pcrj.2010.00001
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