Pharmacoeconomic evaluation of a combination of ipratropium plus albuterol compared with ipratropium alone and albuterol alone in COPD

Mitchell Friedman, Charles W. Serby, Shailendra S. Menjoge, J. Douglas Wilson, Daniel E. Hilleman, Theodore J. Witek

Research output: Contribution to journalArticle

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Abstract

Study objective: To conduct a post hoc pharmacoeconomic evaluation of two double-blind, randomized, prospective, parallel group studies comparing the long-term efficacy and safety of ipratropium combined with albuterol in a single inhalational canister against either bronchodilator agent alone in patients with COPD. Patients: One thousand sixty-seven patients with COPD. Methods: The dose of each bronchodilator was two puffs four times a day (42 μg of ipratropium bromide, 240 μg of albuterol sulfate). Pulmonary function testing was performed on days 1, 29, 57, and 85 of treatment. Outcomes, health-care resource consumption, and costs were compared for the three treatment groups over the 85-day study period. A total of 1,067 patients were randomized in the two studies (albuterol alone, n = 347; ipratropium alone, n = 362; albuterol plus ipratropium, n = 358). Results: Improvement in FEV1 and area under the FEV1 response-time curve from time 0 to 4 h (FEV1AUC0- 4) was significantly greater for the combination of albuterol plus ipratropium than either agent alone on all test days. Compared with albuterol, patients receiving ipratropium and ipratropium plus albuterol experienced significantly fewer COPD exacerbations and patient-days of exacerbation. In addition, the increased frequency of exacerbations observed in the albuterol group was associated with a significant increase in the number of patient hospital days and antibiotic and corticosteroid use. As a result, the total cost of treatment over the study period was significantly less for ipratropium ($156 per patient) and ipratropium plus albuterol ($197 per patient) than for albuterol ($269 per patient). Increased cost- effectiveness, defined as total estimated treatment cost per mean change in FEV1AUC0-4, was observed in both treatment arms containing ipratropium. Conclusions: The inclusion of ipratropium in a pharmacologic treatment regimen is associated with a lower rate of exacerbations in COPD. The result is lower total treatment costs and improved cost-effectiveness.

Original languageEnglish
Pages (from-to)635-641
Number of pages7
JournalChest
Volume115
Issue number3
DOIs
StatePublished - 1999

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Pharmaceutical Economics
Ipratropium
Chronic Obstructive Pulmonary Disease
Albuterol
Health Care Costs
Bronchodilator Agents
Cost-Benefit Analysis
Ipratropium Drug Combination Albuterol
Health Resources
Therapeutics
Reaction Time
Adrenal Cortex Hormones
Anti-Bacterial Agents
Delivery of Health Care
Safety
Costs and Cost Analysis

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine

Cite this

Pharmacoeconomic evaluation of a combination of ipratropium plus albuterol compared with ipratropium alone and albuterol alone in COPD. / Friedman, Mitchell; Serby, Charles W.; Menjoge, Shailendra S.; Wilson, J. Douglas; Hilleman, Daniel E.; Witek, Theodore J.

In: Chest, Vol. 115, No. 3, 1999, p. 635-641.

Research output: Contribution to journalArticle

Friedman, Mitchell ; Serby, Charles W. ; Menjoge, Shailendra S. ; Wilson, J. Douglas ; Hilleman, Daniel E. ; Witek, Theodore J. / Pharmacoeconomic evaluation of a combination of ipratropium plus albuterol compared with ipratropium alone and albuterol alone in COPD. In: Chest. 1999 ; Vol. 115, No. 3. pp. 635-641.
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T1 - Pharmacoeconomic evaluation of a combination of ipratropium plus albuterol compared with ipratropium alone and albuterol alone in COPD

AU - Friedman, Mitchell

AU - Serby, Charles W.

AU - Menjoge, Shailendra S.

AU - Wilson, J. Douglas

AU - Hilleman, Daniel E.

AU - Witek, Theodore J.

PY - 1999

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