Estimation of the Clinical and Economic Impact of an Improvement in Adherence Based on the Use of Once-Daily Single-Inhaler Triple Therapy in Patients with COPD
Marc Miravitlles,1,2 Alicia Marín,2,3 Alicia Huerta,4 David Carcedo,5 Alba Villacampa,5 Jaume Puig-Junoy6 1Pneumology Department, Hospital Universitari Vall d’Hebron, Vall d’Hebron Institut De Recerca (VHIR), Vall d’Hebron Hospital Campus, Barcelona, Spain; 2...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2020-07-01
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| Series: | International Journal of COPD |
| Subjects: | |
| Online Access: | https://www.dovepress.com/estimation-of-the-clinical-and-economic-impact-of-an-improvement-in-ad-peer-reviewed-article-COPD |
| _version_ | 1818855675707523072 |
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| author | Miravitlles M Marín A Huerta A Carcedo D Villacampa A Puig-Junoy J |
| author_facet | Miravitlles M Marín A Huerta A Carcedo D Villacampa A Puig-Junoy J |
| author_sort | Miravitlles M |
| collection | DOAJ |
| description | Marc Miravitlles,1,2 Alicia Marín,2,3 Alicia Huerta,4 David Carcedo,5 Alba Villacampa,5 Jaume Puig-Junoy6 1Pneumology Department, Hospital Universitari Vall d’Hebron, Vall d’Hebron Institut De Recerca (VHIR), Vall d’Hebron Hospital Campus, Barcelona, Spain; 2CIBER De Enfermedades Respiratorias (CIBERES), Barcelona, Spain; 3Pneumology Department, Hospital Germans Trias I Pujol, Badalona, Spain; 4Market Access Department, GlaxoSmithKline SA, Madrid, Spain; 5Hygeia Consulting SL, Madrid, Spain; 6Barcelona School of Management, Universitat Pompeu Fabra (BSM-UPF), Barcelona, SpainCorrespondence: Marc MiravitllesPneumology Department, Hospital Universitari Vall d’Hebron, P. Vall d’Hebron 119-129, Barcelona 08035, SpainTel/ Fax +34 932746083Email marcm@separ.esBackground: Adherence to treatment is key to achieve desired outcomes. In COPD, adherence is generally suboptimal and is impaired by treatment complexity.Objective: To estimate the clinical and economic impact of an improvement in treatment adherence due to an increased use of once-daily single-inhaler triple therapy (SITT) in patients with COPD.Patients and Methods: A 7-state Markov model with monthly cycles was developed. Patients with moderate-to-very severe COPD, for whom triple therapy is indicated, were included. Outcomes and costs were estimated and compared for two scenarios: current distribution of adherent patients treated with multiple inhaler triple therapies (MITT) vs a potential scenario where patients shifted to once-daily SITT. In the potential scenario, adherence improvement due to once-daily SITT attributes was estimated. Costing was based on the Spanish National Health System (NHS) perspective (€ 2019). A 3-year time horizon was defined considering a 3% discount rate for both costs and outcomes.Results: A target population of 185,111 patients with moderate-to-very severe COPD currently treated with MITT was estimated. A 20% increase in the use of once-daily SITT in the potential scenario raised adherence up to 52%. This resulted in 6835 exacerbations and 532 deaths avoided, with 775 LYs and 594 QALYs gained. Total savings reached € 7,082,105. Exacerbation reduction accounted for 61.8% (€ 4,378,201) of savings.Conclusion: Increasing the use of once-daily SITT in patients with moderate-to-very severe COPD treated with triple therapy would be associated with an improvement in adherence, a reduction of exacerbations and deaths, and cost savings for the Spanish NHS.Keywords: COPD, adherence, healthcare, economic evaluation |
| first_indexed | 2024-12-19T08:12:23Z |
| format | Article |
| id | doaj.art-e67ca78887994cbf82ac7eab667d8f88 |
| institution | Directory Open Access Journal |
| issn | 1178-2005 |
| language | English |
| last_indexed | 2024-12-19T08:12:23Z |
| publishDate | 2020-07-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of COPD |
| spelling | doaj.art-e67ca78887994cbf82ac7eab667d8f882022-12-21T20:29:35ZengDove Medical PressInternational Journal of COPD1178-20052020-07-01Volume 151643165455231Estimation of the Clinical and Economic Impact of an Improvement in Adherence Based on the Use of Once-Daily Single-Inhaler Triple Therapy in Patients with COPDMiravitlles MMarín AHuerta ACarcedo DVillacampa APuig-Junoy JMarc Miravitlles,1,2 Alicia Marín,2,3 Alicia Huerta,4 David Carcedo,5 Alba Villacampa,5 Jaume Puig-Junoy6 1Pneumology Department, Hospital Universitari Vall d’Hebron, Vall d’Hebron Institut De Recerca (VHIR), Vall d’Hebron Hospital Campus, Barcelona, Spain; 2CIBER De Enfermedades Respiratorias (CIBERES), Barcelona, Spain; 3Pneumology Department, Hospital Germans Trias I Pujol, Badalona, Spain; 4Market Access Department, GlaxoSmithKline SA, Madrid, Spain; 5Hygeia Consulting SL, Madrid, Spain; 6Barcelona School of Management, Universitat Pompeu Fabra (BSM-UPF), Barcelona, SpainCorrespondence: Marc MiravitllesPneumology Department, Hospital Universitari Vall d’Hebron, P. Vall d’Hebron 119-129, Barcelona 08035, SpainTel/ Fax +34 932746083Email marcm@separ.esBackground: Adherence to treatment is key to achieve desired outcomes. In COPD, adherence is generally suboptimal and is impaired by treatment complexity.Objective: To estimate the clinical and economic impact of an improvement in treatment adherence due to an increased use of once-daily single-inhaler triple therapy (SITT) in patients with COPD.Patients and Methods: A 7-state Markov model with monthly cycles was developed. Patients with moderate-to-very severe COPD, for whom triple therapy is indicated, were included. Outcomes and costs were estimated and compared for two scenarios: current distribution of adherent patients treated with multiple inhaler triple therapies (MITT) vs a potential scenario where patients shifted to once-daily SITT. In the potential scenario, adherence improvement due to once-daily SITT attributes was estimated. Costing was based on the Spanish National Health System (NHS) perspective (€ 2019). A 3-year time horizon was defined considering a 3% discount rate for both costs and outcomes.Results: A target population of 185,111 patients with moderate-to-very severe COPD currently treated with MITT was estimated. A 20% increase in the use of once-daily SITT in the potential scenario raised adherence up to 52%. This resulted in 6835 exacerbations and 532 deaths avoided, with 775 LYs and 594 QALYs gained. Total savings reached € 7,082,105. Exacerbation reduction accounted for 61.8% (€ 4,378,201) of savings.Conclusion: Increasing the use of once-daily SITT in patients with moderate-to-very severe COPD treated with triple therapy would be associated with an improvement in adherence, a reduction of exacerbations and deaths, and cost savings for the Spanish NHS.Keywords: COPD, adherence, healthcare, economic evaluationhttps://www.dovepress.com/estimation-of-the-clinical-and-economic-impact-of-an-improvement-in-ad-peer-reviewed-article-COPDcopdadherencehealthcareeconomic evaluation |
| spellingShingle | Miravitlles M Marín A Huerta A Carcedo D Villacampa A Puig-Junoy J Estimation of the Clinical and Economic Impact of an Improvement in Adherence Based on the Use of Once-Daily Single-Inhaler Triple Therapy in Patients with COPD International Journal of COPD copd adherence healthcare economic evaluation |
| title | Estimation of the Clinical and Economic Impact of an Improvement in Adherence Based on the Use of Once-Daily Single-Inhaler Triple Therapy in Patients with COPD |
| title_full | Estimation of the Clinical and Economic Impact of an Improvement in Adherence Based on the Use of Once-Daily Single-Inhaler Triple Therapy in Patients with COPD |
| title_fullStr | Estimation of the Clinical and Economic Impact of an Improvement in Adherence Based on the Use of Once-Daily Single-Inhaler Triple Therapy in Patients with COPD |
| title_full_unstemmed | Estimation of the Clinical and Economic Impact of an Improvement in Adherence Based on the Use of Once-Daily Single-Inhaler Triple Therapy in Patients with COPD |
| title_short | Estimation of the Clinical and Economic Impact of an Improvement in Adherence Based on the Use of Once-Daily Single-Inhaler Triple Therapy in Patients with COPD |
| title_sort | estimation of the clinical and economic impact of an improvement in adherence based on the use of once daily single inhaler triple therapy in patients with copd |
| topic | copd adherence healthcare economic evaluation |
| url | https://www.dovepress.com/estimation-of-the-clinical-and-economic-impact-of-an-improvement-in-ad-peer-reviewed-article-COPD |
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