Economic evaluations of fluticasone-propionate/salmeterol combination therapy for chronic obstructive pulmonary disease: a review of published studies

ABSTRACT

This review identifies and evaluates the comprehensive reporting of peer-reviewed economic evaluations of the effectiveness of fluticasone-propionate/salmeterol combination (FSC) therapy for maintenance treatment of chronic obstructive pulmonary disease (COPD). Economic evaluations were included if published in English since 2003. Evaluation categories included in the review were cost-effectiveness, cost-utility, and cost-consequence analyses. FSC is cost-effective in comparison to short-acting bronchodilators (SABDs). Cost and outcome differences between FSC and other long-acting therapies were modest. Studies exhibited large variations in populations, designs and environment, limiting the ability to draw conclusions. Many new maintenance treatments for COPD have been approved since 2010. Most have yet to be compared to older treatments like FSC. Evaluations are needed that consider costs and outcomes from a societal perspective (e.g., patients’ ability to keep working) and evaluations that include subgroup analyses to investigate differential impacts according to clusters of patient characteristics.

KEYWORDS:

• Bronchodilator agents
• CHEERS
• chronic obstructive pulmonary disease
• cost-effectiveness
• cost-consequence
• fluticasone
• salmeterol
• pharmacoeconomics
• QHES
• review

Financial & competing interests disclosure

MH Roberts and DW Mapel have received grant funding for COPD-related research from Endo Pharmaceuticals, GlaxoSmithKline, Pfizer and Boehringer-Ingelheim Pharmaceuticals Inc. DW Mapel has also received grant funding from Sunovion Pharmaceuticals. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.