Healthcare expenditures on chronic obstructive pulmonary disease (COPD) have increased substantially globally. Thus, there is a need to find a cost-effective approach for the treatment of COPD. This meta-analysis aimed to evaluate the cost-effectiveness of triple therapy [long acting beta2 agonists (LABA)/long-acting muscarinic antagonist (LAMA)/inhaled corticosteroids (ICS)] versus dual therapy (LABA/LAMA and LABA/ICS) in moderate to severe COPD patients. Studies evaluating the cost-effectiveness of triple therapy versus dual therapy were identified through PubMed and Scopus from 2011 (January) to 2021(January) and meta-analyzed using a random-effects model. Results were presented as standardized mean differences (SMD) of quality-adjusted life years (QALY), life years (LY) gained, Costs, incremental cost-effectiveness ratios (ICER), incremental net monetary benefits (INMB), and incremental net health benefits (INHB). Of the 125 studies identified, four model analyses were included and meta-analyzed. QALY [SMD: 0.22; 95% confidence interval (CI): 0.16, 0.28], LY gained (SMD: 0.14; 95% CI: 0.10, 0.19), ICER (SMD: 0.96; 95% CI: 0.55, 1.38), INMB (SMD: 0.14; 95% CI: 0.12, 0.16), and INHB (SMD: 0.17; 95% CI: 0.13, 0.21) favored triple therapy. The results indicate that triple therapy is cost-effective than dual therapy in moderate to severe COPD patients as it provides more QALY and LY but at an additional cost.
Key words: Meta-analysis, chronic obstructive pulmonary disease, Quality adjusted life years, Incremental cost-effectiveness ratio, net monetary benefit, net health benefit.
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