OBJECTIVES: The aim of this study was to evaluate pharmacoeconomic advisability of the inclusion of the Glycopyrronium bromide into the program of reimbursment of essential drugs (PRED) for the therapy of patients with chronic obstructive pulmonary disease (COPD)

METHODS: Two regimens of baseline therapy of COPD with long-acting muscarinic receptors antagonists were compared: with Tiotropium bromide, and with Glycopyrronium bromide.

The impact on the PRED budget (time horizon was set to 3 years), and cost-effectiveness of these medical technologies were analyzed.. The program of reimbursment of essential drug only includes the costs of pharmacotherapy; therefore, only direct medical costs were taken into account in the analysis of budget impact. A surrogate endpoint was chosen as the medical efficiency criterion in the cost-effectiveness analysis, i.e. the frequency of COPD exacerbations during the therapy with long-acting muscarinic receptors antagonists. The data on the frequency of exacerbations were taken from a Russian epidemiologic study

RESULTS: The substitution of the original Tiotropium bromide with Clycopyrronium bromide reduced the market value of baseline COPD therapy by 43.33% or by almost 8 802 RUB per patient per year. The sensitivity analysis showed that price fluctuations led to 15% changes of these results.

Compare to generic Tiotropium bromide, the use of Glycopyrronium bromide reduced the costs by 12.23% (2 486 RUB per patient per year). The range of changes of this results depending on price fluctuations was 10%.

CONCLUSIONS: It is advisable from the pharmacoeconomic perspective to substitute Tiotropium bromide with Glycopyrronium bromide in PRED