COST-EFFECTIVENESS ANALYSIS OF ROFLUMILAST AS AN ADD-ON TO TRIPLE INHALED THERAPY LABA/LAMA/ICS VS LABA/LAMA/ICS IN PATIENTS WITH SEVERE AND VERY SEVERE COPD IN VIETNAM

Thị Quỳnh Nga Nguyễn1,, Đặng Tú Nguyên Lê1, Trí Phát Nhan 2, Thị Ngọc Vân Trần 3, Thu Thảo Nguyễn4, Thị Hồng Nguyên Trần 1, Dương Duy Khoa Nguyễn1, Thị Hải Yến Nguyễn1, Đình Luyến Phạm 1
1 University of Medicine and Pharmacy at Ho Chi Minh City
2 AstraZeneca Việt Nam company
3 AstraZeneca Viet Nam company
4 Nguyen Tri Phuong hospital

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Abstract

Objectives: Cost-effectiveness analysis of Roflumilast as an add-on to triple inhaled therapy LABA/LAMA/ICS vs triple inhaled therapy in patients with severe and very severe COPD in Vietnam. Research methods: A probabilistic Markov cohort model was developed, including three main states: severe COPD, very severe COPD, and death. This study was carried out from the Social Health Insurance perspective, with the base case time horizon being 30 years and a one-month cycle. Results: The incremental cost-effectiveness ratio (ICER) for LABA/ LAMA/ICS/Roflumilast was 168,577,946 VND/QALY compared with triple inhaled therapy. Input parameters including the cohort’s starting age, the monthly transition probability from severe to very severe COPD in patients receiving LABA/LAMA/ICS/ Roflumilast, discount rate for effectiveness and cost, and standardized mortality rate in patients with severe COPD influenced the overall cost-effectiveness the most. LABA/LAMA/ICS/Roflumilast had a 100% probability of being cost-effective at the threshold of 3 times GDP per capita as recommended by WHO. Conclusion: From the payer perspective, Roflumilast as an add-on to triple inhaled therapy LABA/LAMA/ICS was a cost-effective treatment option compared with triple therapy LABA/LAMA/ICS for patients with severe or very severe COPD in Vietnam.

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