POTENTIAL SAVINGS ACHIEVED THROUGH SWITCHING COPD PATIENTS FROM ICS-CONTAINING REGIMENS TO LAMA-LABA- A DUTCH PERSPECTIVE
Author(s)
Fens T1, Postma MJ2, Voorhaar M3, Soulard S4, Baldwin M5
1University of Groningen, Groningen, The Netherlands, 2Unit of PharmacoEpidemiology & PharmacoEconomics (PE2), Department of Pharmacy, University of Groningen; Institute of Science in Healthy Aging & healthcaRE (SHARE), University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands, 3Boehringer Ingelheim, Alkmaar, The Netherlands, 4Boehringer Ingelheim MIDI, Amsterdam, The Netherlands, 5Boehringer Ingelheim Germany, Ingelheim, Germany
OBJECTIVES: The updated 2017 Global Initiative for Chronic Obstructive Lung Disease (GOLD) Strategy positions a combination of a LAMA (long-acting muscarinic antagonist) and a LABA (long-acting beta2-agonist), as a mainstay treatment for the majority of symptomatic Chronic Obstructive Pulmonary Disease (COPD) patients. The use of -inhaled corticosteroid (ICS) in combination with LABA is reserved for GOLD C patients as an alternative to the combination of LABA and LAMA. The triple therapy (LAMA-LABA-ICS) is reserved for GOLD D patients on LAMA-LABA therapy with further exacerbations. Despite these recommendations, there is considerable use of ICS outside of the GOLD strategy in the Netherlands. METHODS: We elaborated a model that calculates the 5-year impact of the switches between different maintenance therapy options on the Health Care Resource Use (HCRU) in COPD patients. Changes in HCRU were generated based on differences in the risk profile of maintenance COPD therapies for COPD exacerbation, pneumonia and diabetes events. Costs applied were based upon Dutch data. RESULTS: As an illustration switching all ICS patients without ICS recommendation (LABA-ICS and LAMA-LABA-ICS) to LAMA-LABA could avoid 120,466 COPD exacerbations, 34,878 pneumonias and 11,319 diabetes complications in the Netherlands over a 5-year timeframe. This would represent total savings of €263 Million for the Dutch Healthcare System, about 10% of current expenses on COPD care. This equals to €170 per patient per year (€60 euros for drug acquisition, €49 due to less pneumonia, €46 due to less exacerbations, €15 due to less diabetes complications). CONCLUSIONS: The 2017 GOLD guidelines recommend the first-line use of LAMA-LABA, in the treatment of the majority of symptomatic COPD patients. This analysis shows that savings can be achieved in the Netherlands when patients are switched from ICS-containing regimen to LAMA-LABA, mainly due to less ICS-related diabetes and pneumonia events, and less COPD exacerbations.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PRS62
Topic
Health Policy & Regulatory, Health Service Delivery & Process of Care
Topic Subcategory
Health Disparities & Equity, Hospital and Clinical Practices, Treatment Patterns and Guidelines
Disease
Respiratory-Related Disorders
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