Positive Impact of Indacaterol Launch on Guidelines Compliance And Consequences on COPD Daily Treatment Cost In France

VA L U E I N H E A LT H 1 9 ( 2 0 1 6 ) A 3 4 7 – A 7 6 6

A551

PRS14 Adherence To Gold Criteria Strategy In Treatment of Chronic Obstructive Pulmonary Disease (COPD) Patients: Cost Implications In Turkey

savings for the French NHI by increasing the compliance of GPs prescriptions with the COPD guidelines.

Tatar M1, Tuna E2, Senturk A2, Sarioz F3, Konya A4 University, Ankara, Turkey, 2Polar Health Economics and Policy Consultancy, Ankara, Turkey, 3Novartis, İstanbul, Turkey, 4Novartis, Istanbul, Turkey

PRS17 Burden of Non-Tuberculous Mycobacterial Pulmonary Disease In Germany Based on Sick Fund Data Analysis

Objectives: COPD, a major cause of mortality and morbidity globally and in Turkey, is a progressive respiratory disease predominantly caused by smoking. The Global Initiative for Chronic Lung Disease (GOLD) strategy provides an evidence based approach to treatment and prevention of COPD. This study had two main aims as to compare the clinical practice and GOLD recommendations and to assess the cost implications of adherence or non-adherence.  Methods: A two-staged methodology was adopted for the study. First, treatment strategies of 1,610 patients were compared to the recommendations of GOLD 2013 and adherence to the GOLD recommendations were assessed. Second, the costs of treatment with GOLD recommendations and clinical practice were calculated by using the Turkish Social Security Institute’s (SSI) price tariff.  Results: There were major differences in GOLD recommendations and clinical practice. Although LABA+LAMA+ICS treatment is not recommended for GOLD A, B and C patients, this combination was the most widely prescribed treatment (49.5%, 61.2% and 70.3% of patients respectively). In all GOLD groups, except GOLD A category, the annual cost of treatment was higher in clinical practice compared to GOLD recommendations. Although the annual treatment cost per patient by GOLD recommendations was 540.16TL (164€ ) for GOLD B, in actual practice the cost per patient was 981.53 TL (298€ ). Additionally, costs were 763.82 TL (232€ ) vs. 1,063.50 TL (322€ ) for GOLD C and 944.55 TL (286€ ) vs. 1,085.07 TL (329€ ) for GOLD D.  Conclusions: Although GOLD is widely referred to as a gold standard of care, adherence to its recommendations may not always be the case. The results of our study demonstrate that when clinicians do not follow GOLD recommendations, this non-adherence has negative cost implications for the reimbursement agency.

Diel R1, Obradovic M2, Jacob J3 1University Hospital Schleswig-Holstein, Kiel, Germany, 2Insmed GmbH, Frankfurt am Main, Germany, 3Health Risk Institute GmbH, Berlin, Germany

1Hacettepe

PRS15 A 12-Week Cost Analysis to Compare Fluticasone Furoate/ Vilanterol And Beclomethasone Dipropionate/Formoterol In The Treatment of Mild-To-Moderate Asthma

Objectives: Non-tuberculous mycobacterial pulmonary disease (NTMPD) is rare and may in some patients cause severe and irreversible lung damage. Current treatment requires lengthy multi-drug antibiotic regimen that can be poorly tolerated and have limited efficacy. Robust epidemiological data and data on healthcare resource use associated with NTMPD are scarce. This research aims to evaluate incidence, mortality and costs related to NTMPD in Germany.  Methods: A representative sample of statutory health insurance data in Germany was used to identify subjects with NTMPD based on ICD-10 code. Newly diagnosed NTMPD patients in year 2010 and 2011 (N= 125 in total) were followed for a period of three years. A control group (N= 1,250) was constructed matched by age, gender and Charlson co-morbidity index. Incidence of NTMPD was explored. Mortality and resource use were compared between the NTMPD group and matched control group.  Results: Annual incidence rate for NTMPD was 2.3/100.000. In the period between the index quarter and the 3-year follow-up, 22% and 6% of patients died in the NTM and control group, respectively (p< 0.001). Total cost for NTMPD patient in the first year following diagnosis was more than four times higher in NTMPD group vs. control group (€ 14,166 vs. € 3,070, p< .0001). Total cost in NTMPD group however decreased in year 2 and 3 to €  10,921 and €  8,652, respectively, mainly due to less hospitalizations. Majority of costs in NTMPD group were attributable to inpatient stay (49%) and overall medication (29%).  Conclusions: In Germany, patients with NTMPD were associated with high mortality rates and substantial healthcare resource use. With increasing prevalence of this disease in Germany, the burden of caring for these patients could become increasingly taxing on the healthcare system, calling for more effective management and therapies.

Dal Negro RW1, Distante C2, Bonadiman L3, Turco P3, Iannazzo S2 Center for Respiratory Pharmacoeconomics & Pharmacoepidemiology, Verona, Italy, 2SIHS SRL, Torino, Italy, 3Research & Clinical Governance, Verona, Italy

PRS18 Costs of Perennial Allergic Rhinitis And Asthma Increase with Level of Severity And Level of Disease Control

Objectives: The present study was an observational, retrospective analysis to compare the treatment costs of mild-to-moderate asthmatic patients assuming Fluticasone furoate/Vilanterol (F/V) 92/22 µg delivered via the Ellipta device once a day or Beclomethasone dipropionate/Formoterol (B/F) 100/6 µg delivered via the Nexthaler device twice a day, over a 12-week period.  Methods: Clinical data and consumption of healthcare resources were derived from the database of the Lung Unit of the Specialist Medical Centre (CEMS), Verona, Italy. The perspective was the Italian NHS. The propensity score (PS) method designed as matching on baseline covariates, as gender, age, forced expiratory volume in 1 second (FEV1) and presence of comorbidities, was applied.  Results: 77 patients treated with B/F in the period February-September 2015, and 40 patients treated with F/V were identified. The PS-matching process returned a cohort of 40 B/F patients matched with 40 F/V patients. The mean (±SE) number of relapses per patient during the follow-up was 0.53 (±0.12) in B/F and 0.28 (±0.07) in F/V patients. The average number of hospitalizations was 0.15 (±0.06) in B/F, and 0.08 (±0.04) in F/V patients. The difference between the two groups in terms of FEV1(L) improvement vs baseline was 0.11 in favour of F/V group (p =  0.007). The mean total cost during the study period, calculated as hospitalization, GP and specialist visits, rescue medications and treatment cost, was €  443.97 per patient treated with B/F, and €  281.11 per patient treated with F/V.  Conclusions: F/V showed the potential for enhanced clinical outcomes and reduced costs when compared to B/F.

Belhassen M1, Demoly P2, Bloch-Morot E3, de Pouvourville G4, Ginoux M1, Chartier A5, Laforest L1, Serup-Hansen N6, Toussi M7, van Ganse E1 1PharmacoEpidemiology Lyon, LYON, France, 2Department of Pulmonology, Montpellier, France, 3French Association for Continual Medical Education of Allergists, Reims, France, 4ESSEC Business School, Cergy-Pontoise, France, 5ALk Abello, Courbevoie, France, 6ALK, Hørsholm, Denmark, 7IMS Health, Paris La Défense, France

1National

PRS16 Positive Impact of Indacaterol Launch on Guidelines Compliance And Consequences on COPD Daily Treatment Cost In France Thonnelier C1, Duco J2, Benjamin K2, Bloino C3 Pharma SAS, Rueil-Malmaison, France, 2Novartis Pharma, Rueil-Malmaison, France, 3Novartis, Rueil-Malmaison, France

1Novartis

Objectives: Indacaterol is a Long Acting Beta-2 Agonist (LABA) which was launched in 2011 for chronic obstructive pulmonary disease (COPD). The current guidelines in France - from the Global Initiative for Chronic Obstructive Lung Disease (GOLD) in 2011 - recommend a bronchodilatator as a first line treatment. But the most prescribed therapy is a fixed dose combination (FDC) of a LABA with a corticosteroid (ICS), normally dedicated from severe to very severe COPD patients with an history of repeated exacerbations. The aim of this study was to demonstrate the positive impact of Indacaterol launch on treatment guidelines compliance and on daily treatment cost (DTC).  Methods: Data from the IMS Disease Analyzer panel - 1200 General Practitioners (GPs) who provides anonymized information about their prescriptions- were used. Data about COPD therapeutic schemes were screened from 2009 to 2015. Market shares of every therapeutic schemes were also extrapolated to the situation where Indacaterol would not be launched. Costs of scheme were extracted from the National Health Insurance (NHI) database. The DTC per patient was then compared between both situations, with or without Indacaterol.  Results: The COPD DTC was stable between 2009 and 2011 as about 1.59€  per patient. Since then the DTC has decreased with or without Indacaterol launch thanks to price decreases of several products. Four years after Indacaterol launch, the market share of LABA+ICS FDC lost about seventeen points. The DTC decreased to 1.32€  per patient with Indacaterol versus 1.36€  per patient without Indacaterol launch and generated a total economy of about 46 million euros.  Conclusions: This analysis demonstrated that the Indacaterol launch was able to generate remarkable

Objectives: Allergic rhinoconjunctivitis (ARC) is a common disorder, with a prevalence of 17-29% in European adults. Asthma affects around 6% of the French population with considerable Medical Resource Utilization (MRU). Our study aimed to detail MRU and related direct cost in Perennial Allergic Rhinitis (PAR), with or without concomitant allergic asthma (AA) in France. Methods: Using French Electronic Health Records (EHRs), we identified in 2010 two cohorts of patients, based on General Practitioners’ diagnoses, prescribing and clinical data. The first cohort included patients with PAR but no AA, while the second cohort included patients with PAR and concomitant AA. For each patient, the medical record was linked to corresponding claims data with reimbursed MRU and costs between 2011 and 2013. In each cohort, sub-groups analyses were performed according to severity of rhinitis and level of asthma control.  Results: The mean total annual cost for a patient with PAR and no AA was 247€  in 2013. This varied from 202€  to 298€  depending on rhinitis severity. Medical consultations made up almost 50% of these costs, while allergy drug made up 10%. For patients with PAR and concomitant AA, the mean annual cost varied between 403€  and 550€ , depending on the level of asthma control. Asthma drugs accounted for 20% and medical consultations for 35% of the costs.  Conclusions: This innovative study linking diagnoses from EHRs to claims data (MRU) was one of the first of its kind to be conducted in France, certainly in allergy. It collected valid data on PAR management, with or without concomitant AA, and on related costs. There was a clear relationship between MRU or associated costs, and severity of PAR and control of AA. Improved disease control for patients with PAR and AA would decrease the burden of disease. PRS19 The Cost of Asthma In Italy Dal Negro RW1, Distante C2, Bonadiman L3, Turco P3, Iannazzo S2 Center for Respiratory Pharmacoeconomics & Pharmacoepidemiology, Verona, Italy, 2SIHS SRL, Torino, Italy, 3Research & Clinical Governance, Verona, Italy

1National

Objectives: Asthma is a common chronic disease of the airways with a significant burden on patients’ quality of life and on the society. The SIRIO study estimated in 2007 an average direct cost of 1,075 €  per patient/year in Italy. The objective of this study was to update this information.  Methods: An observational retrospective analysis was conducted in 817 patients from the Lung Unit of the Specialist Medical Centre (CEMS), Verona (Italy), over the period June 2012-December 2015. Clinical and economic data were obtained for the 12±2 months prior the assignation at the specialist centre (pre-study) and recorded during 36 months of follow-up. The cost prospective was the Italian National Health Service. Clinical data were measured in terms of forced expiratory volume in 1 second (FEV1%) and number of relapses. Healthcare resources as number of hospitalization, visits, and treatments were recorded.  Results: The cohort had 42.96% male prevalence, mean (±SE) age of 49.06 (±0.64) years, and FEV1 87.47% (±0.81%). Comorbidities were present in 69.16% of the cohort. Relapses in pre-study were 0.91 (±0.09) per patient/year. The average FEV1 significantly improved in the follow-up (delta= 7.23%, p<  0.001) and a trend towards