Cost-effectiveness of tiotropium versus salmeterol: the POET-COPD trial

Hoogendoorn M, Al MJ, Beeh K-M, Bowles D, von der Schulenburg JMG, Lungershausen J, Monz BU, Schmidt H, Vogelmeier C, Rutten-van Molken MPMH (2013)
European Respiratory Journal 41(3): 556-564.

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Abstract
The aim of this study was to perform a 1-yr trial-based cost-effectiveness analysis (CEA) of tiotropium versus salmeterol followed by a 5-yr model-based CEA. The within-trial CEA, including 7,250 patients with moderate to very severe chronic obstructive pulmonary disease (COPD), was performed alongside the 1-yr international randomised controlled Prevention of Exacerbations with Tiotropium (POET)-COPD trial comparing tiotropium with salmeterol regarding the effect on exacerbations. Main end-points of the trial-based analysis were costs, number of exacerbations and exacerbation days. The model-based analysis was conducted to extrapolate results to 5 yrs and to calculate quality-adjusted life years (QALYs). 1-yr costs per patient from the German statutory health insurance (SHI) perspective and the societal perspective were 126 (95% uncertainty interval (UI) (sic)55-195) and (sic)170 (95% UI (sic)77-260) higher for tiotropium, respectively. The annual number of exacerbations was 0.064 (95% UI 0.010-0.118) lower for tiotropium, leading to a reduction in exacerbation-related costs of (sic)87 (95% UI (sic)19-157). The incremental cost-effectiveness ratio was 1,961 per exacerbation avoided from the SHI perspective and (sic)2,647 from the societal perspective. In the model-based analyses, the 5-yr costs per QALY were (sic)3,488 from the SHI perspective and (sic)8,141 from the societal perspective. Tiotropium reduced exacerbations and exacerbation-related costs, but increased total costs. Tiotropium can be considered cost-effective as the resulting cost-effectiveness ratios were below commonly accepted willingness-to-pay thresholds.
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Hoogendoorn M, Al MJ, Beeh K-M, et al. Cost-effectiveness of tiotropium versus salmeterol: the POET-COPD trial. European Respiratory Journal. 2013;41(3):556-564.
Hoogendoorn, M., Al, M. J., Beeh, K. - M., Bowles, D., von der Schulenburg, J. M. G., Lungershausen, J., Monz, B. U., et al. (2013). Cost-effectiveness of tiotropium versus salmeterol: the POET-COPD trial. European Respiratory Journal, 41(3), 556-564.
Hoogendoorn, M., Al, M. J., Beeh, K. - M., Bowles, D., von der Schulenburg, J. M. G., Lungershausen, J., Monz, B. U., Schmidt, H., Vogelmeier, C., and Rutten-van Molken, M. P. M. H. (2013). Cost-effectiveness of tiotropium versus salmeterol: the POET-COPD trial. European Respiratory Journal 41, 556-564.
Hoogendoorn, M., et al., 2013. Cost-effectiveness of tiotropium versus salmeterol: the POET-COPD trial. European Respiratory Journal, 41(3), p 556-564.
M. Hoogendoorn, et al., “Cost-effectiveness of tiotropium versus salmeterol: the POET-COPD trial”, European Respiratory Journal, vol. 41, 2013, pp. 556-564.
Hoogendoorn, M., Al, M.J., Beeh, K.-M., Bowles, D., von der Schulenburg, J.M.G., Lungershausen, J., Monz, B.U., Schmidt, H., Vogelmeier, C., Rutten-van Molken, M.P.M.H.: Cost-effectiveness of tiotropium versus salmeterol: the POET-COPD trial. European Respiratory Journal. 41, 556-564 (2013).
Hoogendoorn, Martine, Al, Maiwenn J., Beeh, Kai-Michael, Bowles, David, von der Schulenburg, J. Matthias Graf, Lungershausen, Juliane, Monz, Brigitta U., Schmidt, Hendrik, Vogelmeier, Claus, and Rutten-van Molken, Maureen P. M. H. “Cost-effectiveness of tiotropium versus salmeterol: the POET-COPD trial”. European Respiratory Journal 41.3 (2013): 556-564.
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