Vis enkel innførsel

dc.contributor.authorNielsen, Runeen_US
dc.contributor.authorKankaanranta, Hannuen_US
dc.contributor.authorBjermer, Leifen_US
dc.contributor.authorLange, Peteren_US
dc.contributor.authorArnetorp, Sofieen_US
dc.contributor.authorHedegaard, Mortenen_US
dc.contributor.authorStenling, Annaen_US
dc.contributor.authorMittmann, Nicoleen_US
dc.description.abstractObjective: 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.rightsAttribution-NonCommercial-NoDerivs CC BY-NC-NDeng
dc.titleCost effectiveness of adding budesonide/formoterol to tiotropium in COPD in four Nordic countriesen_US
dc.typePeer reviewed
dc.typeJournal article
dc.rights.holderCopyright 2013 Elsevier Ltd.
dc.source.journalRespiratory Medicine
dc.subject.nsiVDP::Medical sciences: 700::Basic medical, dental and veterinary sciences: 710::Clinical pharmacology: 739eng
dc.subject.nsiVDP::Medical sciences: 700::Clinical medical sciences: 750::Lung diseases: 777eng
dc.subject.nsiVDP::Medisinske fag: 700::Basale medisinske, odontologiske og veterinærmedisinske fag: 710::Klinisk farmakologi: 739nob
dc.subject.nsiVDP::Medisinske fag: 700::Klinisk medisinske fag: 750::Lungesykdommer: 777nob

Tilhørende fil(er)


Denne innførselen finnes i følgende samling(er)

Vis enkel innførsel

Attribution-NonCommercial-NoDerivs CC BY-NC-ND
Med mindre annet er angitt, så er denne innførselen lisensiert som Attribution-NonCommercial-NoDerivs CC BY-NC-ND