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Cost-effectiveness of adding budesonide/formoterol to tiotropium in severe COPD patients in four Nordic countries
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2012 (English)In: European Respiratory Journal, Vol. 40, no Suppl 56Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Objective: To assess the cost-effectiveness of budesonide/formoterol (B/F)+tiotropium (TIO) versus placebo (PBO)+TIO for the treatment of chronic obstructive pulmonary disease (COPD) patients eligible for inhaled corticosteroid/ long-acting β2-agonist from societal and healthcare perspectives in Denmark, Finland, Norway and Sweden.Method: The cost-effectiveness analysis was based on the 12-week, randomised, double-blind CLIMB trial (NCT00496470) of 659 COPD patients with pre-bronchodilator FEV1 ≤50%, and at least one severe exacerbation (hospitalisation, emergency room visit or systemic glucocorticosteroids) the preceding year. Subjects were treated with B/F 320/9µg bid+TIO 18µg qd or PBO bid+TIO 18µg qd. Effectiveness was defined as the number of exacerbations avoided. A sub-analysis included antibiotics in the definition of an exacerbation. Resource use from the trial was combined with 2010 Danish (DKK), Finnish (€), Norwegian (NOK) and Swedish (SEK) unit costs. The incremental cost-effectiveness ratios (ICERs) were estimated by bootstrapping.Results: From a societal perspective, the ICER was estimated at €174 per exacerbation avoided (pEA) in Finland while B/F+TIO was dominant in the other countries. From a healthcare perspective, B/F+TIO was dominant in Norway and the ICERs were estimated at DKK 1,580 (€212), €307, SEK 1,573 (€165) pEA for Denmark, Finland and Sweden, respectively. Including antibiotics decreased ICERs by 8-15%. Sensitivity analyses showed that results were overall robust.Conclusion: The results indicate that B/F+TIO represents a clinical and economic benefit to health systems and society for the treatment of COPD in the Nordic countries.

Place, publisher, year, edition, pages
2012. Vol. 40, no Suppl 56
National Category
Respiratory Medicine and Allergy
URN: urn:nbn:se:umu:diva-103806OAI: diva2:815472
Available from: 2015-06-01 Created: 2015-06-01 Last updated: 2015-06-01

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Stenling, Anna
Respiratory Medicine and Allergy

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