Economic impact of implementing prescription of single-inhaler triple therapies versus current multiple-inhaler triple therapies for COPD in the Apulia Region
Abstract Background The most impacting direct costs associated to COPD for the National Health Systems (NHS) are those related to accesses to the emergency room and hospital admissions, due to the onset of one or more COPD exacerbations. At the same time, severe COPD treatment, that often require a...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-10-01
|
| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-022-08640-9 |
| _version_ | 1811192426342121472 |
|---|---|
| author | Emanuela Resta Giulia Scioscia Donato Lacedonia Carla Maria Irene Quarato Francesco Panza Onofrio Resta Giorgia Lepore Enrico Buonamico Valentina Di Lecce Giovanna Elisiana Carpagnano Maria Pia Foschino Barbaro Noemi Rossi |
| author_facet | Emanuela Resta Giulia Scioscia Donato Lacedonia Carla Maria Irene Quarato Francesco Panza Onofrio Resta Giorgia Lepore Enrico Buonamico Valentina Di Lecce Giovanna Elisiana Carpagnano Maria Pia Foschino Barbaro Noemi Rossi |
| author_sort | Emanuela Resta |
| collection | DOAJ |
| description | Abstract Background The most impacting direct costs associated to COPD for the National Health Systems (NHS) are those related to accesses to the emergency room and hospital admissions, due to the onset of one or more COPD exacerbations. At the same time, severe COPD treatment, that often require a combination of medicaments, represents a substantial economic burden for the National Health Systems (NHS). This study aimed to evaluate the potential saving deriving from the implementation in the prescription of the two currently available single-inhaler triple therapies (SITTs) versus the currently used multiple-inhaler triple therapies (MITTs) in an eligible COPD population residing in the Apulia Region. Methods A budget impact model was developed hypothesizing the progressive replacement of the different MITTs on the reference market (Scenario A) with the pre-established SITTs, assuming a degree of penetration of 30%, 50% and 100% (Scenario B). Drug costs were based on prices published on the Official Gazette and therapy durations were based on prescribing information over the year 2019 (IQVIA™ prescription dataset). Results Our analysis showed that the extemporaneous MITT with the highest prevalence on the reference market was the inhaled corticosteroids/long-acting β2-agonists (ICS/LABA) combination plus a long-acting muscarinic antagonists (LAMA). This association of medicaments was paradoxically also the one associated to the highest expense value. The expanded use of a pre-established ICS/LAMA/LABA SITT was associated to a significant economic saving, ranging from a minimum of -€ 1,108,814 (SITT use: 30%) to a maximum of -€ 3,658,950 (SITT use: 100%). The cheapest pre-established SITT contained the fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) combination. Conclusion A pre-fixed ICS/LAMA/LABA SITT is cost-saving, compared to the different currently used extemporaneous MITTs. Clinicians should consider the potential benefits of finding less expensive regimens while maintaining adequate efficacy in the prescriptive decision making process of COPD patients. |
| first_indexed | 2024-04-11T23:52:33Z |
| format | Article |
| id | doaj.art-05af155237f14faa986c1572b5778d84 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-11T23:52:33Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-05af155237f14faa986c1572b5778d842022-12-22T03:56:26ZengBMCBMC Health Services Research1472-69632022-10-0122111010.1186/s12913-022-08640-9Economic impact of implementing prescription of single-inhaler triple therapies versus current multiple-inhaler triple therapies for COPD in the Apulia RegionEmanuela Resta0Giulia Scioscia1Donato Lacedonia2Carla Maria Irene Quarato3Francesco Panza4Onofrio Resta5Giorgia Lepore6Enrico Buonamico7Valentina Di Lecce8Giovanna Elisiana Carpagnano9Maria Pia Foschino Barbaro10Noemi Rossi11Translational Medicine and Health System Management, Department of Economy, University of FoggiaDepartment of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Universitario “Riuniti” di Foggia, University of FoggiaDepartment of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Universitario “Riuniti” di Foggia, University of FoggiaDepartment of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Universitario “Riuniti” di Foggia, University of FoggiaPopulation Health Unit, “Salus in Apulia Study”, Research Hospital, National Institute of Gastroenterology “Saverio de Bellis”Department of Basic Medical Sciences, Neuroscience and Sense Organs, Section of Respiratory Disease, University “Aldo Moro” of BariDepartment of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Universitario “Riuniti” di Foggia, University of FoggiaDepartment of Basic Medical Sciences, Neuroscience and Sense Organs, Section of Respiratory Disease, University “Aldo Moro” of BariDepartment of Basic Medical Sciences, Neuroscience and Sense Organs, Section of Respiratory Disease, University “Aldo Moro” of BariDepartment of Basic Medical Sciences, Neuroscience and Sense Organs, Section of Respiratory Disease, University “Aldo Moro” of BariDepartment of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Universitario “Riuniti” di Foggia, University of FoggiaDepartment of Law, Economics and Human Sciences (DIGIES) “Mediterranea”, University of Reggio CalabriaAbstract Background The most impacting direct costs associated to COPD for the National Health Systems (NHS) are those related to accesses to the emergency room and hospital admissions, due to the onset of one or more COPD exacerbations. At the same time, severe COPD treatment, that often require a combination of medicaments, represents a substantial economic burden for the National Health Systems (NHS). This study aimed to evaluate the potential saving deriving from the implementation in the prescription of the two currently available single-inhaler triple therapies (SITTs) versus the currently used multiple-inhaler triple therapies (MITTs) in an eligible COPD population residing in the Apulia Region. Methods A budget impact model was developed hypothesizing the progressive replacement of the different MITTs on the reference market (Scenario A) with the pre-established SITTs, assuming a degree of penetration of 30%, 50% and 100% (Scenario B). Drug costs were based on prices published on the Official Gazette and therapy durations were based on prescribing information over the year 2019 (IQVIA™ prescription dataset). Results Our analysis showed that the extemporaneous MITT with the highest prevalence on the reference market was the inhaled corticosteroids/long-acting β2-agonists (ICS/LABA) combination plus a long-acting muscarinic antagonists (LAMA). This association of medicaments was paradoxically also the one associated to the highest expense value. The expanded use of a pre-established ICS/LAMA/LABA SITT was associated to a significant economic saving, ranging from a minimum of -€ 1,108,814 (SITT use: 30%) to a maximum of -€ 3,658,950 (SITT use: 100%). The cheapest pre-established SITT contained the fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) combination. Conclusion A pre-fixed ICS/LAMA/LABA SITT is cost-saving, compared to the different currently used extemporaneous MITTs. Clinicians should consider the potential benefits of finding less expensive regimens while maintaining adequate efficacy in the prescriptive decision making process of COPD patients.https://doi.org/10.1186/s12913-022-08640-9Economic impactNational Health SystemsCOPDSingle-inhaler triple therapyMultiple-inhaler triple therapy |
| spellingShingle | Emanuela Resta Giulia Scioscia Donato Lacedonia Carla Maria Irene Quarato Francesco Panza Onofrio Resta Giorgia Lepore Enrico Buonamico Valentina Di Lecce Giovanna Elisiana Carpagnano Maria Pia Foschino Barbaro Noemi Rossi Economic impact of implementing prescription of single-inhaler triple therapies versus current multiple-inhaler triple therapies for COPD in the Apulia Region BMC Health Services Research Economic impact National Health Systems COPD Single-inhaler triple therapy Multiple-inhaler triple therapy |
| title | Economic impact of implementing prescription of single-inhaler triple therapies versus current multiple-inhaler triple therapies for COPD in the Apulia Region |
| title_full | Economic impact of implementing prescription of single-inhaler triple therapies versus current multiple-inhaler triple therapies for COPD in the Apulia Region |
| title_fullStr | Economic impact of implementing prescription of single-inhaler triple therapies versus current multiple-inhaler triple therapies for COPD in the Apulia Region |
| title_full_unstemmed | Economic impact of implementing prescription of single-inhaler triple therapies versus current multiple-inhaler triple therapies for COPD in the Apulia Region |
| title_short | Economic impact of implementing prescription of single-inhaler triple therapies versus current multiple-inhaler triple therapies for COPD in the Apulia Region |
| title_sort | economic impact of implementing prescription of single inhaler triple therapies versus current multiple inhaler triple therapies for copd in the apulia region |
| topic | Economic impact National Health Systems COPD Single-inhaler triple therapy Multiple-inhaler triple therapy |
| url | https://doi.org/10.1186/s12913-022-08640-9 |
| work_keys_str_mv | AT emanuelaresta economicimpactofimplementingprescriptionofsingleinhalertripletherapiesversuscurrentmultipleinhalertripletherapiesforcopdintheapuliaregion AT giuliascioscia economicimpactofimplementingprescriptionofsingleinhalertripletherapiesversuscurrentmultipleinhalertripletherapiesforcopdintheapuliaregion AT donatolacedonia economicimpactofimplementingprescriptionofsingleinhalertripletherapiesversuscurrentmultipleinhalertripletherapiesforcopdintheapuliaregion AT carlamariairenequarato economicimpactofimplementingprescriptionofsingleinhalertripletherapiesversuscurrentmultipleinhalertripletherapiesforcopdintheapuliaregion AT francescopanza economicimpactofimplementingprescriptionofsingleinhalertripletherapiesversuscurrentmultipleinhalertripletherapiesforcopdintheapuliaregion AT onofrioresta economicimpactofimplementingprescriptionofsingleinhalertripletherapiesversuscurrentmultipleinhalertripletherapiesforcopdintheapuliaregion AT giorgialepore economicimpactofimplementingprescriptionofsingleinhalertripletherapiesversuscurrentmultipleinhalertripletherapiesforcopdintheapuliaregion AT enricobuonamico economicimpactofimplementingprescriptionofsingleinhalertripletherapiesversuscurrentmultipleinhalertripletherapiesforcopdintheapuliaregion AT valentinadilecce economicimpactofimplementingprescriptionofsingleinhalertripletherapiesversuscurrentmultipleinhalertripletherapiesforcopdintheapuliaregion AT giovannaelisianacarpagnano economicimpactofimplementingprescriptionofsingleinhalertripletherapiesversuscurrentmultipleinhalertripletherapiesforcopdintheapuliaregion AT mariapiafoschinobarbaro economicimpactofimplementingprescriptionofsingleinhalertripletherapiesversuscurrentmultipleinhalertripletherapiesforcopdintheapuliaregion AT noemirossi economicimpactofimplementingprescriptionofsingleinhalertripletherapiesversuscurrentmultipleinhalertripletherapiesforcopdintheapuliaregion |