Cost-Effectiveness of Glycopyrronium Bromide Compared with Tiotropium in Patients with Chronic Obstructive Pulmonary Disease in Sweden

Madlaina Costa-Scharplatz, Björn Ställberg, Pankaj Goyal, Yumi Asukai, Jean-Bernard Gruenberger, David Price

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)


OBJECTIVES: The objective of this study was to compare the cost effectiveness of once-daily Seebri Breezhaler(®) (glycopyrronium bromide) 50 µg with Spiriva(®) (tiotropium bromide) 18 µg in the maintenance treatment of chronic obstructive pulmonary disease (COPD) in the Swedish setting.

METHODS: A previously published COPD Markov model accounting for disease progression and treatment discontinuation was used. Disease progression included the annual decline in forced expiratory volume in the first second (FEV1) and occurrence of any exacerbations. Efficacy in the model consisted of FEV1 improvement between baseline and 12 weeks and the annual risk ratio of having an exacerbation compared to placebo. These clinical efficacy inputs were derived from a 1-year head-to-head trial comparing glycopyrronium 50 µg to tiotropium 18 µg. Utility values and cost estimates were obtained from the literature. The base-case analysis was performed for a 3-year time horizon. Cost and effects were discounted with 3 % in accordance to Swedish guidelines. Uncertainty was assessed by one-way and probabilistic sensitivity analyses.

RESULTS: Glycopyrronium was found to be less costly and more effective than tiotropium in moderate to severe COPD patients with cost savings of 5197 Swedish kronor (<euro>570, US$725) per patient over a 3-year time horizon. The probabilistic sensitivity analysis indicated that over 99 % of the iterations produced dominant results for glycopyrronium.

CONCLUSION: Glycopyrronium bromide 50 µg once daily can be considered a cost effective alternative to tiotropium bromide 18 µg once daily in the maintenance treatment of COPD patients in Sweden.

Original languageEnglish
Pages (from-to)637-645
Number of pages9
JournalApplied Health Economics and Health Policy
Issue number6
Early online date1 Sept 2015
Publication statusPublished - Dec 2015

Bibliographical note

Funding sources: This study was funded by Novartis Pharma AG.


  • Chronic Obstructive Pulmonary Disease
  • Glycopyrromium Bromide
  • Sweden


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