dc.contributor.author | Nielsen, Rune | en_US |
dc.contributor.author | Kankaanranta, Hannu | en_US |
dc.contributor.author | Bjermer, Leif | en_US |
dc.contributor.author | Lange, Peter | en_US |
dc.contributor.author | Arnetorp, Sofie | en_US |
dc.contributor.author | Hedegaard, Morten | en_US |
dc.contributor.author | Stenling, Anna | en_US |
dc.contributor.author | Mittmann, Nicole | en_US |
dc.date.accessioned | 2015-04-10T10:49:35Z | |
dc.date.available | 2015-04-10T10:49:35Z | |
dc.date.issued | 2013-11 | eng |
dc.identifier.issn | 0954-6111 | |
dc.identifier.uri | https://hdl.handle.net/1956/9750 | |
dc.description.abstract | Objective: Assess the cost effectiveness of budesonide/formoterol (BUD/FORM) Turbuhaler®+tiotropium (TIO) HandiHaler® vs. placebo (PBO)+TIO in patients with chronic obstructive pulmonary disease (COPD) eligible for inhaled corticosteroids/long-acting β2-agonists (ICS/LABA). Methods: The cost-effectiveness analysis was based on the 12-week, randomised, double-blind CLIMB trial. The study included 659 patients with pre-bronchodilator forced expiratory volume in 1 s ≤ 50% and ≥1 exacerbation requiring systemic glucocorticosteroids or antibiotics the preceding year. Patients received BUD/FORM 320/9 μg bid + TIO 18 μg qd or PBO bid + TIO 18 μg qd. Effectiveness was defined as the number of severe exacerbations (hospitalisation/emergency room visit/systemic glucocorticosteroids) avoided. A sub-analysis included antibiotics in the definition of an exacerbation. Resource use from CLIMB was combined with Danish (DKK), Finnish (€), Norwegian (NOK) and Swedish (SEK) unit costs (2010). The incremental cost-effectiveness ratios (ICERs) for BUD/FORM + TIO vs. PBO + TIO were estimated using descriptive statistics and uncertainty around estimates using bootstrapping. Analyses were conducted from the societal and healthcare perspectives in Denmark, Finland, Norway and Sweden. Results: From a societal perspective, the ICER was estimated at €174/severe exacerbation avoided in Finland while BUD/FORM + TIO was dominant in the other countries. From the healthcare perspective, ICERs were DKK 1580 (€212), €307 and SEK 1573 (€165) per severe exacerbation avoided for Denmark, Finland and Sweden, respectively, while BUD/FORM + TIO was dominant in Norway. Including antibiotics decreased ICERs by 8–15%. Sensitivity analyses showed that results were overall robust. Conclusion: BUD/FORM + TIO represents a clinical and economic benefit to health systems and society for the treatment of COPD in the Nordic countries. | en_US |
dc.language.iso | eng | eng |
dc.publisher | Elsevier | eng |
dc.rights | Attribution-NonCommercial-NoDerivs CC BY-NC-ND | eng |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/ | eng |
dc.subject | Budesonide/formoterol | eng |
dc.subject | Tiotropium | eng |
dc.subject | Cost-effectiveness | eng |
dc.subject | Nordic | eng |
dc.subject | COPD | eng |
dc.title | Cost effectiveness of adding budesonide/formoterol to tiotropium in COPD in four Nordic countries | en_US |
dc.type | Peer reviewed | |
dc.type | Journal article | |
dc.date.updated | 2015-04-01T08:25:46Z | en_US |
dc.description.version | publishedVersion | en_US |
dc.rights.holder | Copyright 2013 Elsevier Ltd. | |
dc.identifier.doi | https://doi.org/10.1016/j.rmed.2013.06.007 | |
dc.identifier.cristin | 1094788 | |
dc.source.journal | Respiratory Medicine | |
dc.source.40 | 107 | |
dc.source.14 | 11 | |
dc.source.pagenumber | 1709-1721 | |
dc.subject.nsi | VDP::Medical sciences: 700::Basic medical, dental and veterinary sciences: 710::Clinical pharmacology: 739 | eng |
dc.subject.nsi | VDP::Medical sciences: 700::Clinical medical sciences: 750::Lung diseases: 777 | eng |
dc.subject.nsi | VDP::Medisinske fag: 700::Basale medisinske, odontologiske og veterinærmedisinske fag: 710::Klinisk farmakologi: 739 | nob |
dc.subject.nsi | VDP::Medisinske fag: 700::Klinisk medisinske fag: 750::Lungesykdommer: 777 | nob |