Table 3.
Sensitivity analysis results
| Parameter | Value | Source | Average yearly cost/patient B/F (€) | Average yearly cost/patient F/S (€) | Difference B/F vs F/S % |
|---|---|---|---|---|---|
| Mean drugs dosages | |||||
| Base case | 568 μg die B/F; 783 μg die F/S | PATHOS study26 | 1,311.60 | 1,811.50 | −27.6% |
| Min | 333 μg die B/F; 445 μg die F/S | PATHOS study dosages,26 lowest limit SD | 1,032.80 | 1,436.30 | −28.1% |
| Max | 803 μg die B/F; 1,121 μg die F/S | PATHOS study dosages,26 highest limit SD | 1,590.40 | 2,186.70 | −27.3% |
| DDD | 4 UD for B/F 160 μg, 2 UD for B/F 320 μg; 2 UD for F/S* | WHO29 | 1,397.00 | 1,604.10 | −12.9% |
| Drugs prices | |||||
| Base case | Actual public price reimbursed by INHS (no generics available) | Italian reimbursement price list | 1,311.60 | 1,811.50 | −27.6% |
| Reduction for generic commercialization | B/F actual price; F/S generic (−70% vs actual price) | Decreto Balduzzi30 | 1,311.60 | 1,203.10 | 9.0% |
| Reduction for generic commercialization | B/F generic (−55% vs actual price); F/S generic (−70% vs actual price) | Decreto Balduzzi30 | 940.90 | 1,203.10 | −21.8% |
| Price of F/S Elpenhaler® | Farmadatia | 1,311.60 | 1,590.90 | −17.6% | |
| Only F/S 500/50 μg dosage | Italian clinical practice | 1,311.60 | 1,626.50 | −19.4% | |
| COPD-related hospitalization costs | |||||
| Base case | €3,218.00 | Lucioni et al,15 COPD hospitalization cost | 1,311.60 | 1,811.50 | −27.6% |
| Min | €2,923.00 | Lucioni et al,15 lowest limit 95% CI | 1,267.30 | 1,749.60 | −27.6% |
| Max | €3,513.00 | Lucioni et al,15 highest limit 95% CI | 1,355.80 | 1,873.50 | −27.6% |
| Pneumonia-related hospitalization costs | |||||
| Base case | €3,603.00 | Merito et al,28 pneumonia hospitalization cost | 1,311.60 | 1,811.50 | −27.6% |
| Min | €3,205.60 | Merito et al,28 age class >85 | 1,294.50 | 1,782.10 | −27.4% |
| Max | €3,717.60 | Merito et al,28 age class 65–74 | 1,316.50 | 1,820.00 | −27.7% |
Notes:
Mean dosages based on DDD weighted for days treatment were delivered.
Farmadati is a database containing all the administrative, legislative and commercial information about the medicines for human or veterinary use registered in Italy, equivalent medicines, homeopathic and parapharmaceutical products; available at: http://www.farmadati.it. PATHOS study (An Investigation of the Past 10 Years Health Care for Primary Care Patients with Chronic Obstructive Pulmonary Disease; clinical trial identifier NCT01146392, ClinicalTrials.gov). Elpenhaler® (Elpen Pharmaceutical Co. Inc., Attica, Greece).
Abbreviations: B/F, budesonide/formoterol; CI, confidence interval; COPD, chronic obstructive pulmonary disease; DDD, defined daily dose; die, daily; F/S, fluticasone/salmeterol; INHS, Italian National Health Service; Max, maximum; Min, minimum; SD, standard deviation; UD, unit dose; vs, versus; WHO. World Health Organization.