PRS49 - COST-EFFECTIVENESS OF THE FIXED-DOSE COMBINATION TIOTROPIUM + OLODATEROL VERSUS TIOTROPIUM BASED ON THE DYNAGITO TRIAL RESULTS IN FRANCE

Abstract

Combinations of long-acting bronchodilators are recommended to reduce the rate of chronic obstructive pulmonary disease (COPD) exacerbations. Evidence from a recent head-to-head trial, DYNAGITO, suggests that the fixed dose combination tiotropium+olodaterol (TIO+OLO) produces a reduction in the risk of exacerbating compared with tiotropium monotherapy (TIO). This study assessed the cost-effectiveness of TIO+OLO versus TIO in the French setting. A recently developed COPD patient-level simulation model was used to estimate the lifetime effects and costs for 15,000 patients receiving either TIO+OLO or TIO by applying the difference in annual exacerbation rate as observed in the DYNAGITO trial. The unit costs for treatment medication, COPD maintenance treatment, COPD exacerbations (moderate and severe) and pneumonias were obtained from relevant sources in France. The main outcomes were the annual exacerbation rate, quality-adjusted life-years (QALYs) and lifetime costs. Analyses were performed from a societal perspective. Patients receiving TIO+OLO benefitted from QALYs gain as compared to those treated with TIO: on average + 0.042 QALYs per patient over lifetime (PSA: 0.043 (95% UI: -0.015; 0.102)). The higher treatment medication costs for TIO+OLO versus TIO (+€1,640) were not completely compensated by the reduction in exacerbation costs (-€1,540), but the resulting difference in total costs between TIO + OLO versus TIO was small +€123 (PSA: €131 (95% UI: -€1021; €1026). The base case cost-effectiveness ratio (ICER) of TIO+OLO vs OLO was €2,900 per QALY. This finding was consistent across all sensitivity analyses conducted. On the basis of the results of the DYNAGITO trial, TIO+OLO is cost-effective versus TIO in COPD patients in France with a low cost per QALY.