The Potential Societal Cost Benefits Of Increasing Patient Satisfaction By Using An Inhaler With Improved Features Compared To Spiriva® Handihaler® For The Management Of Chronic Obstructive Pulmonary Disease (Copd) In The Uk


      Spiriva® Handihaler® (tiotropium) is available in a single capsule dry powder inhaler (DPI) for the treatment of COPD. As exacerbations and hospitalisations represent an important driver of the cost and morbidity of COPD, high priority should be given to interventions aimed at delaying the progression of disease, preventing exacerbations, and reducing the risk of comorbidities to alleviate the clinical and economic burden of disease. The potential societal cost benefits of improving treatment satisfaction, due to improved characteristics of an inhaler were investigated.


      The eligible adult patient population was based on confirmed COPD diagnoses in UK, with the proportion of patients receiving Spiriva® Handihaler® based on market research data. The annual number of work days lost due to COPD was based on data from the UK. The monetary value of a productive day was based on the average monthly salary in the UK. A conservative assumption was made about the increased risk of a productive day being lost – associated with level of patient satisfaction to their treatment – by calculating an approximate number of unscheduled hospitalisations that users of a new inhaler would experience in the previous 12 months relative to Spiriva® HandiHaler®. Patient satisfaction with their inhaler was based on inhaler features that relate to ease of use and ergonomics and compared Spiriva® HandiHaler® to an improved inhaler.


      The frequency of unscheduled hospitalisations for the new inhaler and Spiriva® HandiHaler® users were calculated at 0.34 and 0.38, resulting in 68 and 76 productive days lost annually, respectively. The total annual societal cost per patient was €9,851 with the new inhaler and €10,891 with Spiriva® HandiHaler®. The new inhaler costs €1,040 less per annum than Spiriva® Handihaler®.


      New inhalers with improved features have the potential to offer substantial societal cost savings in COPD compared with Spiriva® Handihaler®.