Cost-Utility Analysis Of Erdosteine for the Prevention of Exacerbations in Patients With COPD in the Czech Republic
Author(s)
Klara Lamblova, MSc1, Katerina Doleckova, MSc2, Denisa Kubesova, MSc3, Tomáš Doležal, PhD, MD3.
1Senior HTA Consultant, VALUE OUTCOMES, an IQVIA business, Praha, Czech Republic, 2VALUE OUTCOMES, an IQVIA business, Praha, Czech Republic, 3VALUE OUTCOMES, an IQVIA business, Prague, Czech Republic.
1Senior HTA Consultant, VALUE OUTCOMES, an IQVIA business, Praha, Czech Republic, 2VALUE OUTCOMES, an IQVIA business, Praha, Czech Republic, 3VALUE OUTCOMES, an IQVIA business, Prague, Czech Republic.
OBJECTIVES: To evaluate the cost-utility of adding erdosteine to conventional therapy in patients with moderate to severe chronic obstructive pulmonary disease (COPD) who are at risk of exacerbations in the Czech Republic.
METHODS: A one-year decision tree model was developed in TreeAge Pro to project quality-adjusted life years (QALYs) and treatment costs of erdosteine added to conventional COPD therapy compared to conventional COPD therapy alone, from the healthcare payer’s perspective. Model pathways were defined based on the presence and severity of exacerbations (mild, moderate, severe), and the occurrence of associated hospitalization. Transition probabilities for exacerbation, including exacerbation severity, and subsequent hospitalization were primarily derived from the RESTORE trial.Utility values for treated COPD patients with exacerbations (stratified by severity) and without exacerbation were sourced from the RESTORE study using mapping algorithms between SGRQ and EQ-5D, and from published literature adjusted for age and gender, respectively. Drug acquisition costs were derived from the SÚKL database of registered medicinal products, while the costs of exacerbations and hospitalizations were obtained from a Czech costing study and local DRG database (CZ-DRG version 7.0). Sensitivity analyses assessed the robustness of the results.
RESULTS: Erdosteine reduced the annual exacerbation rate by 19.5% and decreased the proportion of patients hospitalized due to severe exacerbations by 7.8%. Compared to conventional therapy alone, erdosteine resulted in an incremental QALY gain of 0.014 at an additional cost of €46, yielding an ICER of €3,243 per QALY gained. Sensitivity analyses confirmed that the ICER remained below the willingness-to-pay threshold of €47,873 per QALY gained.
CONCLUSIONS: Adding erdosteine to conventional therapy in COPD patients at risk of exacerbations is a cost‑effective option from the Czech healthcare payer’s perspective, primarily due to reducing the exacerbation rate. To our knowledge, this is the first cost-effectiveness analysis of erdosteine for preventing exacerbations in COPD patients.
METHODS: A one-year decision tree model was developed in TreeAge Pro to project quality-adjusted life years (QALYs) and treatment costs of erdosteine added to conventional COPD therapy compared to conventional COPD therapy alone, from the healthcare payer’s perspective. Model pathways were defined based on the presence and severity of exacerbations (mild, moderate, severe), and the occurrence of associated hospitalization. Transition probabilities for exacerbation, including exacerbation severity, and subsequent hospitalization were primarily derived from the RESTORE trial.Utility values for treated COPD patients with exacerbations (stratified by severity) and without exacerbation were sourced from the RESTORE study using mapping algorithms between SGRQ and EQ-5D, and from published literature adjusted for age and gender, respectively. Drug acquisition costs were derived from the SÚKL database of registered medicinal products, while the costs of exacerbations and hospitalizations were obtained from a Czech costing study and local DRG database (CZ-DRG version 7.0). Sensitivity analyses assessed the robustness of the results.
RESULTS: Erdosteine reduced the annual exacerbation rate by 19.5% and decreased the proportion of patients hospitalized due to severe exacerbations by 7.8%. Compared to conventional therapy alone, erdosteine resulted in an incremental QALY gain of 0.014 at an additional cost of €46, yielding an ICER of €3,243 per QALY gained. Sensitivity analyses confirmed that the ICER remained below the willingness-to-pay threshold of €47,873 per QALY gained.
CONCLUSIONS: Adding erdosteine to conventional therapy in COPD patients at risk of exacerbations is a cost‑effective option from the Czech healthcare payer’s perspective, primarily due to reducing the exacerbation rate. To our knowledge, this is the first cost-effectiveness analysis of erdosteine for preventing exacerbations in COPD patients.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE301
Topic
Economic Evaluation
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)