Cost Effectiveness Working Group ERS 2017

1. ERS 2017
Milan, 9th September 2017
Cost Effectiveness Working Group
Meeting

2. Agenda
• Attendees and core members
• Working group goals
• Priorities for future research
o Review potential studies
o Other research ideas
o Funding opportunities
o Setting priorities
• Additional items

3. Attendees
• J van Boven (chair)
• A Azuma
• A Cruz
• U Seppala
• G Crater
• P Rivera Ortega

4. WG core members
• Lead: Associate prof. dr. Jonathan D Campbell (Denver, USA)
• Assistant prof. dr. Job FM van Boven (Groningen, Netherlands)
• Assistant prof. dr. Mohsen Sadatsafavi (Vancouver, Canada)
• Assistant prof. dr. R Brett McQueen (Denver, USA)

5. Goals of cost-effectiveness working group
• Perform real-life and modelling studies on the cost-effectiveness
of respiratory treatments
• Raise awareness on the importance of cost-effectiveness and
identify gaps in currect research
• Provide input for clinical studies with an economic component
• Provide workshops/education on health economic issues in
respiratory medicine inside and outside REG

6. Core Member Selected Recent Publications
• Asthma CEA
o Whittington MD, McQueen RB, Ollendorf DA, Tice JA, Chapman RH, Pearson SD, Campbell JD.
Assessing the value of mepolizumab for severe eosinophilic asthma: a cost-effectiveness analysis.
Annals of Allergy, Asthma & Immunology. 2016 Dec 3. S1081-1206(16):31267-4.
o Dilokthornsakul P, Chaiyakunapruk N, Campbell JD. Does the use of efficacy or effectiveness evidence
in cost-effectiveness analysis matter? Journal of Asthma. 2017 Jan 2. 54(1):17-23.
o Price DB, van Boven JF, Law LM, Cifra A, McQueen RB. Cost comparison of asthma treatment in 12-
week study: caution about matching and short follow-up. Multidiscip Respir Med 2016; 11:39
o Kim CH, Dilokthornsakul P, Campbell JD, van Boven JF. Asthma cost-effectiveness analyses: Are we
using the recommended outcomes in estimating value? JACI In Practice 2017 in-press.
• COPD CEA
o Van Boven JF, McQueen RB, Price DB. COPD case finding: effective, but also cost-effective? Lancet
Respir Med 2016; 4(10):e49
o Van Boven JF, Kocks JW, Postma MJ. Cost-effectiveness and budget impact of the fixed dose dual
bronchodilator combination tiotropium-olodaterol for patients with COPD in The Netherlands. Int J COPD
2016; 11:2191-2201
o JF van Boven. Costly comorbidities of COPD: the ignored side of the coin? European Respiratory
Journal 2017; 49(7):1700917

7. Gaps identified through review
• van der Schans S, Goossens LM, Boland MR, Kocks JW, Postma MJ, van Boven JF, Rutten-van
Mölken MP. Systematic Review and Quality Appraisal of Cost-Effectiveness Analyses of Pharmacologic
Maintenance Treatment for Chronic Obstructive Pulmonary Disease: Methodological Considerations
and Recommendations. Pharmacoeconomics. 2017 Jan;35(1):43-63
• CH Kim, P Dilokthornsakul, JD Campbell, JF van Boven. Asthma cost-effectiveness analyses: Are we
using the recommended outcomes in estimating value? Journal of Allergy & Clinical Immunology: In
Practice 2017
• Both reviews identified the need for:
- Incorporation of side-effects (local/systemic), comorbidities and adherence
- Standardization of costs and (respiratory) outcomes
- Better reflection of treatment patterns in real-life

8. Asthma Gaps

9. COPD Gaps
• Efficacy versus Effectiveness and how this translates to Cost-
Effectiveness
o Exacerbations: should be standardized; severe: hospitalization, non-severe: ED
or GP visit.
o Adherence
o Populations
o Comorbidities
o Long-term side effects and their clinical and economic consequences
• Utility: standardize estimates for GOLD stages and exacerbations.
o Outcomes: Ideally both the EQ-5D and a COPD specific HRQoL should be used.
• Perspective: payer versus societal
o Indirect costs

10. Prioritizing Research
Topics/research areas for consideration
1 Indirect Costs of Asthma, COPD, and Overlap Syndrome (ACOS)
2 Quality of life measurement and preference scores in real-life
asthma and COPD health states
3 Long-run clinical and economic consequences of oral steroids
4 Comparison of effectiveness vs. efficacy in asthma/COPD models
5 Validating long-term outcomes predicted by models vs. real-life
data
6 Rare disease modelling
7 Cost-effectiveness of new technologies in asthma/COPD
8 Development of respiratory disease specific CEA guidelines
Other ideas?

11. Solving the Puzzle
• Marrying high-impact research with funding and expertise
o Respiratory CEA gaps identified
o Respiratory CEA expertise identified
o Funding welcomed
– CEA working group is seeking pilot funding routed through REG

12. Active research seeking funding
• PharmacoEconomics journal has requested a review of the value
of approved and emerging asthma biologics (Dr. McQueen is
leading this effort)
o Aim of paper is to systematically review economic data on biologic
treatments for asthma and to provide critical insight into key drivers of
cost-effectiveness
o This effort could be organized through the REG CEA Working group
o We are seeking a funding collaborator for this research
– Robert.McQueen@ucdenver.edu

13. Any other business?
Contact us for new REG studies:
• USA: Jon D Campbell (jon.campbell@ucdenver.edu)
• Europe: Job FM van Boven (j.f.m.van.boven@rug.nl)