Cost-effectiveness analyses of pharmacologic maintenance treatment for chronic obstructive pulmonary disease: A systematic review

S. Van Der Schans*, L.M. Goossens, M.R. Boland, J. Kocks, M.J. Postma, J.F. Van Boven, M.P. Rutten-van Mölken

*Corresponding author voor dit werk

OnderzoeksoutputAcademic

Samenvatting

Objectives: We aimed to systematically review recently published articles that reported the cost-effectiveness of COPD maintenance treatments, with a focus on key findings, quality, and methodological issues. Methods: A systematic literature search was performed in EMBASE, Pubmed, UK-NHS (NHS-EED) and EURONHEED. All relevant articles published between 2011 and 2015 in either Dutch, English or German were included. Main study characteristics, methods and outcomes were extracted and critically assessed. The QHES was used as basis for quality assessment, but additional items were addressed as well. Results: Eighteen recent pharmacoeconomic analyses of COPD maintenance treatments were identified. Papers reported the cost-effectiveness of LAMA monotherapy (n= 6), PDE-4 inhibitors (n= 4), LABA/ICS combinations (n= 4), LABA monotherapy (n= 2) and LABA/LAMA combinations (n= 2). All but two studies were funded by the manufacturer and all studies indicated favourable cost-effectiveness; however, the number of QALYs gained was small. Less than half of the studies did report a COPD-specific outcome in addition to a generic outcome (mostly QALY). Exacerbation and mortality rates were found to be the main drivers of cost-effectiveness. According to the QHES, the quality of the studies was generally sufficient, but additional assessment revealed that most studies did poorly represent the cost-effectiveness of real-life medication use. Conclusions: The majority of studies showed that pharmacologic COPD maintenance treatment is cost-effective, but most studies poorly reflected real-life drug use. Consistent and COPD-specific methodology is recommended.
Originele taal-2English
Pagina's (van-tot)A556
Aantal pagina's1
TijdschriftValue in Health
Volume19
Nummer van het tijdschrift7
DOI's
StatusPublished - nov.-2016

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