Table 6.
One-way sensitivity analysis: LABA/ICS + roflumilast vs LABA/ICS
| Parameter | Base case and range (low estimate; base case; high estimate) | ICER at low parameter estimate | ICER at high parameter estimate, CHF per QALY gained | Variation in ICER between low and high estimates |
|---|---|---|---|---|
| Relative ratios of exacerbation rates | (0.74; 0.835; 0.95)a | Roflumilast dominant | 84,682 | N/Ab |
| Hospital case fatality rate, % | (0; 7.7; 15) | Roflumilast dominant | 13,732 | N/Ab |
| Cost of hospital-treated exacerbation, CHF | (10,511; 13,139; 15,767) | 16,321 | 6591 | 9730 |
| Annual discount rate, cost | (0%; 2.5%; 5%) | 15,109 | 8973 | 6136 |
| Annual discount rate, QALY | (0%; 2.5%; 5%) | 8765 | 14,563 | 5798 |
| Background rate of exacerbations in very severe COPD, per patient per year | (1.95; 2.436; 2.92) | 14,409 | 9411 | 4998 |
| Background rate of exacerbations in severe COPD, per patient per year | (1.6; 2.0; 2.4) | 13,735 | 9586 | 4149 |
| Proportion of hospital treated exacerbations among all exacerbations in very severe COPD | (0.208; 0.244; 0.280) | 13,312 | 10,016 | 3296 |
| Proportion of hospital treated exacerbations among all exacerbations in severe COPD | (0.133; 0.155; 0.177) | 12,828 | 10,246 | 2582 |
Notes: Base case ICER for LABA/ICS + roflumilast vs LABA/ICS; CHF 11,456 per QALY gained.
a
Exacerbation rate reduction statistically significant;
b
in sensitivity analyses where cost-effectiveness changes to dominance, range of ICERs is not applicable.
Abbreviations: LABA, long-acting beta-agonists; ICS, inhaled corticosteroids; ICER, incremental cost-effectiveness ratio; QALY, quality-adjusted life years; COPD, chronic obstructive pulmonary disease.