Using cost-effectiveness analysis to sharpen formulary decision-making: the example of tiotropium at the Veterans Affairs health care system

Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Ebere OnukwughaSylvain DeLisle

Abstract

To identify a cost-saving subset of criteria for the use of tiotropium at a Veterans Affairs Medical Center based on a cost-effectiveness analysis with ipratropium as the comparator. Retrospective analysis of electronic medical records for the calendar year 2004 was conducted. The sample was drawn from a population at the Baltimore Veterans Affairs Medical Center that had a confirmed diagnosis of chronic obstructive pulmonary disease (COPD) and had filled prescriptions for ipratropium. The tiotropium sample was based on a modeled cohort of COPD patients who had received tiotropium. The analysis was conducted from the perspective of the Veterans Affairs Health Care System. The outcome was the incremental cost-effectiveness of tiotropium versus ipratropium. The incremental cost-effectiveness ratio (ICER) was $2360 per avoided exacerbation. Tiotropium cost-effectiveness increased with COPD severity and was cost-saving in patients with very severe disease (ICER = $-1818) and in patients with a previous COPD-related hospitalization (ICER = $-4472). The ICER was most sensitive to the relative effectiveness and price of tiotropium. Results identified the levels of treatment effectiveness and price beyond which tiotropium would become ...Continue Reading

References

Feb 28, 2002·The European Respiratory Journal·R CasaburiT Witek
Oct 30, 2003·The European Respiratory Journal. Supplement·P BurneyG W Hagan
Nov 6, 2003·JAMA : the Journal of the American Medical Association·Don D SinNick R Anthonisen
Feb 26, 2004·The European Respiratory Journal·J B OostenbrinkW Vincken
May 28, 2005·Archivos de bronconeumología·A J García RuizF Martos Crespo
Jul 21, 2005·The Annals of Pharmacotherapy·Heather Somand, Tami L Remington
Sep 25, 2007·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Josephine A MauskopfPaul Trueman

❮ Previous
Next ❯

Citations

Nov 19, 2010·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·O ZanioloM Miravitlles
Sep 17, 2010·BMC Pulmonary Medicine·Konstantinos Kostikas, Demosthenes Bouros
Jul 9, 2010·Journal of Medical Economics·Josephine A MauskopfMelissa D Juniper
Nov 5, 2015·Journal of Medical Economics·Thomas R EinarsonMichiel E H Hemels
May 18, 2016·The Lancet. Respiratory Medicine·MeiLan K HanMark T Dransfield
Jan 25, 2014·Journal of Rehabilitation Research and Development·Kevin T StroupeCharlesnika T Evans

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.