Volume 19 Issue 1 March 2010Original Research
Economic analyses comparing tiotropium with ipratropium
or salmeterol in UK patients with COPD
Pages 68-74
*Ray Gania, Jane Griffina, Steve Kellyb, Maureen Rutten-van Mölkenc
a
Market Access, Pricing and Outcomes Research, Boehringer Ingelheim Ltd, Berkshire, UK
b
Outcomes Research & Evidence Based Medicine, Pfizer UK Ltd, Walton Oaks, UK
c
Erasmus Medical Centre, Institute for Medical Technology Assessment, Rotterdam, The Netherlands
Received 6 October 2009 • Accepted 27 December 2009 • Online 21 January 2010
Abstract
AIMS: This study presents a cost-effectiveness and budget impact analysis comparing cost and outcomes for UK patients with COPD
treated with either tiotropium, ipratropium or salmeterol.
METHODS: A previously-published COPD cost-effectiveness model was adapted for the UK, then used to estimate the cost-effectiveness of
tiotropium compared to salmeterol and ipratropium. Additional epidemiological data were used to estimate the budget impact of
switching patients from ipratropium or salmeterol to tiotropium.
RESULTS: In England, the estimated annual cost per patient on tiotropium was £1350, on salmeterol was £1404, and on ipratropium was
£1427; in Scotland/Wales/Northern Ireland (S/W/NI) these costs were £1439, £1565, and £1631, respectively. Tiotropium patients
experienced better quality-adjusted life-years (QALYs) across all comparisons, and this option was therefore dominant compared to
salmeterol and ipratropium. The probability of tiotropium being dominant ranged from 72% to 87% across comparisons. At a willingnessto-
pay threshold of £20,000 per QALY, tiotropium had at least a 97% chance of being cost-effective. The estimated annual saving per
primary care trust (PCT) of switching patients from salmeterol and ipratropium to tiotropium in England was £230,000 and in S/W/NI was
£160,000.
CONCLUSIONS: Tiotropium is a cost-effective alternative to ipratropium and salmeterol, and switching COPD patients from ipratropium and
salmeterol to tiotropium could result in considerable cost savings for PCTs along with improvements in quality-of-life.
Keywords
COPD, economic, budget impact, cost-effectiveness, tiotropium, salmeterol, ipratropium
* Corresponding author. Ray Gani Tel: +44 (0)1344 741 139 Fax: +44 (0)1344 742 701 Email: ray.gani@boehringer-ingelheim.com | |
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