Cost-utility of triple versus dual inhaler therapy in moderate to severe asthma

ABSTRACT: Background: An important proportion of asthma patients remain uncontrolled despite using inhaled corticosteroids and long-acting beta-agonists. Clinical guidelines recommend, in these patients, using add-on long-acting muscarinic antagonists (triple therapy) to treatment with high doses of inhaled corticosteroids-long-acting beta2-agonist (dual therapy). The purpose of this study was to assess the cost-effectiveness of triple therapy versus dual therapy for patients with severe asthma. Methods: A probabilistic Markov model was created to estimate the cost and quality-adjusted life-years (QALYs) of patients with severe asthma in Colombia. Total costs and QALYS of dual and triple therapy were calculated over a lifetime horizon. Multiple sensitivity analyses were conducted. Cost-effectiveness was evaluated at a willingness-to-pay value of $19,000. Results: The model suggests a potential gain of 1.55 QALYs per patient per year on triple therapy with respect to dual therapy. We observed a difference of US$304 in discounted cost per person-year on triple therapy with respect to dual therapy. The incremental cost-effectiveness ratio was US$196 in the probabilistic model. In the sensitivity analysis, our base-case results were robust to variations in all assumptions and parameters. Conclusion: In conclusion, triple therapy in patients with moderate-severe asthma was cost-effective. Using triple therapy emerges with our results as an alternative before using oral corticosteroids or biologics, especially in resource-limited settings.

• Autores: Buendía Rodríguez, Jefferson Antonio; Guerrero Patiño, Diana
• Tipo de recurso: Article of investigation
• Fecha de publicación: 2021
• Institución: Universidad de Antioquia
• Repositorio: Repositorio UdeA
• Idioma: eng
• OAI Identifier: oai:bibliotecadigital.udea.edu.co:10495/45147
• Acceso en línea: https://hdl.handle.net/10495/45147
• Palabra clave: Corticoesteroides - economía; Adrenal Cortex Hormones - economics; Análisis de Costo-Efectividad; Cost-Effectiveness Analysis; Asma; Asthma; Agonistas de Receptores Adrenérgicos beta 2; Adrenergic beta-2 Receptor Agonists; Bromuro de Tiotropio; Tiotropium Bromide; Técnicas de Apoyo para la Decisión; Decision Support Techniques; Colinérgicos; Cholinergic Agents; Colombia; Quimioterapia Combinada; Drug Therapy, Combination; Cadenas de Markov; Markov Chains; Nebulizadores y Vaporizadores; Nebulizers and Vaporizers; Años de Vida Ajustados por Calidad de Vida; Quality-Adjusted Life Years; https://id.nlm.nih.gov/mesh/D000305; https://id.nlm.nih.gov/mesh/D000094703; https://id.nlm.nih.gov/mesh/D001249; https://id.nlm.nih.gov/mesh/D058666; https://id.nlm.nih.gov/mesh/D000069447; https://id.nlm.nih.gov/mesh/D003661; https://id.nlm.nih.gov/mesh/D018678; https://id.nlm.nih.gov/mesh/D003105; https://id.nlm.nih.gov/mesh/D004359; https://id.nlm.nih.gov/mesh/D008390; https://id.nlm.nih.gov/mesh/D009330; https://id.nlm.nih.gov/mesh/D019057
• Rights: openAccess
• License: http://creativecommons.org/licenses/by/2.5/co/