Comparative Health-Care Cost Advantage of Ipratropium over Tiotropium in COPD Patients

作者：Dormuth Colin R^*; Yamaguchi Jesse; Wilmer Brett; Hosick David; Stuermer Til; Carney Greg

来源：Value in Health, 2012, 15(2): 269-276.

DOI：10.1016/j.jval.2011.10.014

• COPD
• health care
• respiratory disease
• tiotropium
• utilization

Objective: To compare the total direct health-care costs of patients treated with tiotropium and ipratropium. Methods: We conducted a cohort study of health-care costs in British Columbia, Canada, by comparing new patients on tiotropium with new patients on ipratropium. Direct health-care costs for study patients were measured in the first 2 years after initiating inhaled anticholinergic treatment. Differences in direct health-care costs between tiotropium and ipratropium patients were estimated by using quantile regression. We analyzed cost differences in the 10th percentile, median, and 90th percentile of patients by cost. High-dimensional propensity score analysis was used as a method of adjustment for potential confounding factors. Results: The study population had 3,140 tiotropium patients and 26,182 ipratropium patients. Higher health system costs in patients who started on tiotropium instead of ipratropium were observed in patients in the median and 10th percentile. The magnitude of these increases was comparable to the price difference between the two drugs. Health system costs in the 90th percentile were not significantly different between tiotropium and ipratropium patients. Conclusions: The results of this study did not support the preferential use of tiotropium over ipratropium as a basis for savings in direct health-care costs.

• 出版日期2012-4