Analysis of the economic impact of mometasone/formoterol in chronic obstructive pulmonary disease in Colombia

Análisis del impacto presupuestal de mometasona/formoterol en enfermedad pulmonar obstructiva crónica en Colombia

Introduction: mometasone/formoterol is a metered-dose pressurized inhaler that contains corticosteroids and a long-acting beta-agonist; it provides efficient symptom control in cases of COPD. The recommended dose is two inhalations, twice daily.

Objetive: to develop an analysis of the economic impact of the introduction of mometasone/formoterol in the Colombian healthcare system over the period from 2013 to 2017. This analysis gives an estimate of the financial implications of the use of this medication in patients older than 40 years with chronic obstructive pulmonary disease.

Materials and methods: from the perspective of the healthcare system, a model was designed for determining the effect of the introduction of mometasone/formoterol on the system’s resources. The guidelines and recommendations used in such studies were followed, taking into account the specific target population, the study’s perspective, and the time frame. Clinical and epidemiological information was drawn from the available medical literature (Colombian guidelines), and costs were gathered from the national handbook of drug prices (SISMED) for the year 2013. Cost analysis was done in two scenarios: with and without discount, using a constant 3%-rate for the years under study. The robustness of the results was evaluated by a univariate sensitivity analysis.

Results: through the population-based model, for a cohort of 46.927.125 people in Colombia, and applying epidemiological data, it is estimated that a total number of 119.962 patients would have the specific indication to receive treatment with a fixed combination. The net annual costs (2013-2017) with the inclusion of mometasone-formoterol were $88.050; $88.052; $88.053; $88.053; and $88.054 Colombian pesos respectively for each year. The impact of the total budget of mometasone/formoterol (without discount) over a five-year period is $11.76 (11 million Colombian pesos, approximately). The sensitivity analysis was focused on the total impact on the budget and its relation with the compliance to fixed-dose combinations.

Conclusion: the results of the analysis of budget impact shows that the inclusion of mometasone/formoterol in the treatment of chronic obstructive pulmonary disease, compared with other fixed-dose combinations, has the potential to reduce the total costs of the budget in the Colombian healthcare system.