Pharmacoeconomic analysis of using of tiotropium bromide (Spiriva® Respimat®) as adjunctive therapy in patients with asthma in the Russian Federation

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access


For the first time in Russian economic conditions clinical and economic evaluation of the appropriateness of tiotropium bromide as adjunctive therapy (in addition to the standard therapy) was carried out in patients with severe asthma. Markov model was built using direct and indirect costs, data efficiency and effectiveness; research horizon was 1 year. An additional model was comparing tiotropium bromide (plus standard therapy) and omalizumab (plus standard therapy) with standard therapy. Sensitivity analysis and the budget impact analysis were done. The modeling showed that the use of the strategy of «tiotropium plus standard therapy» increased the likelihood of patients to remain in a state of controlled asthma compared to other strategies. The strategy «tiotropium plus standard therapy» reduced the likelihood of a severe exacerbation compared with standard therapy. Thus, taking into account high frequency of hospitalization of patients with asthma in Russia that was shown in pharmacoepidemiological studies, the use of tiotropium is absolutely appropriate medical technology from the standpoint of clinical and economic analysis. The strategy of using tiotropium is the most preferred strategy in terms of the budget impact analysis when compared with the strategy of omalizumab: the use of tiotropium strategy allows to save substantial budget funds that can be further used to treat a considerable number of patients.

Full Text

Restricted Access

About the authors

A S Kolbin

Pavlov First Saint Petersburg State Medical University; St. Petersburg State University


T L Galankin

Pavlov First Saint Petersburg State Medical University

M A Proskurin

St. Petersburg State University

Y E Balykina

St. Petersburg State University


  1. Архипов B.B. Клиническая фармакология ингаляционных глюкокортикостероидов. Новые перспективы повышения контроля над бронхиальной астмой. От науки к практике. Практическая пульмонология. 2014, № 1, с. 1-8.
  2. Rabe K.F., Vermeire P.A., Soriano J.B. et al. Clinical management of asthma in 1999: the Asthma Insights and Reality in Europe (AIRE) stud. Eur. Respir. J. 2000, v. 16, р. 802-807.
  3. Partridge M.R., van der Molen T., Myrseth S.E. et al. Attitudes and actions of asthma patients on regular maintenance therapy: the INSPIRE study. BMC Pulm. Med. 2006, v. 6, р. 13.
  4. Demoly P., Annunziata K., Gubba E. et al. Repeated cross-sectional survey of patient-reported asthma control in Europe in the past 5 years. Eur. Respir. Rev. 2012, v. 21, р. 66-74.
  5. Ненашева Н.М. Новые возможности достижения контроля астмы с помощью тиотропия бромида. Эффективная фармакотерапия. 2014, № 29, с. 2-10.
  6. Yohannes A.M., Connolly M.J., Hanania N.A. Ten years of tiotropium: clinical impact and patient perspectives. Int. J. Chron. Obstruct. Pulmon. Dis. 2013, v. 8, р. 117-125.
  7. Adams K.S., Lowe D.K. Tiotropium for adults with inadequately controlled persistent asthma. Ann. Pharmacother. 2013, v. 47, р. 117-123.
  8. Министерство здравоохранения Российской Федерации. «Об утверждении отраслевого стандарта «клинико-экономические исследования. Общие положения». 27.05.2011.
  9. Клинико-экономический анализ (оценка, выбор медицинских технологий и управления качеством медицинской помощи). Под ред. П.А. Воробьева. 2004, Ньюдиамед. М., 404 с.
  10. Планирование и проведение клинических исследований лекарственных средств. Под ред. Белоусова Ю.Б. М.: Общество клинических исследователей. 2000, 579 с.
  11. Gold M.R. Cost-effectiveness in Health and Medicine. New York: Oxford University Press. 1996, 425 р.
  12. Walley T., Haycox А., Boland A. Pharmacoeconomics. Elsevier Health Sciences. 2004, 216 р.
  13. Оценка медицинских технологий. Рекомендации. Под общей редакцией Ю.Б. Белоусова. М.: Издательство ОКИ. 2013, 40 с.
  14. Josephine A. Mauskopf et al. Principles of Good Practice for Budget Impact Analysis: Report of the ISPOR Task Force on Good Research Practices - Budget Impact Analysis, Value in Health. 2007, v. 10, р. 336-347.
  15. Brosa M. et al. Principios, métodos y aplicaciones del analisis del impacto presupuestario en el sector sanitario. Pharmacoeconomics - Spanish Research Articles. 2005, v. 2, р. 65-78.
  16. http://www.
  19. Peters S.P., Kunselman S.J., Icitovic N. et al. Tiotropium bromide step-up therapy for adults with uncontrolled asthma. N. Engl. J. Med. 2010, v. 363, р. 1715-1726.
  20. Fardon T., Haggart K., Lee D.K. et al. A proof of concept study to evaluate stepping down the dose of fluticasone in combination with salmeterol and tiotropium in severe persistent asthma. Respir. Med. 2007, v. 101, р. 1218-1228.
  21. Kerstjens H.A., Engel M., Dahl R. et al. Tiotropium in asthma poorly controlled with standard combination therapy. N. Engl. J. Med. 2012, v. 367, р. 1198-1207.
  22. Yoshida M., Nakano T., Fukuyama S. et al. Effects of tiotropium on lung function in severe asthmatics with or without emphysematous changes. Pulm. Pharmacol. Ther. 2013, v. 26, р. 159-166.
  23. Рубаник Т.В., Привалова Е.В., Сергеева Г.Р. и соавт. Опыт применения тиотропия в лечении больных бронхиальной астмой и ХОБЛ. Пульмонология и аллергология. 2009, № l, с. 26-30.
  24. Willson J., Bateman E., Pavord I. et al. Cost effectiveness of tiotropium in patients with asthma poorly controlled on inhaled glucocorticosteroids and long-acting β-Agonists. Appl. Health Econ. Health Policy. 2014, v. 12, р. 447-459.
  25. Полевая О.А. Основные причины частых госпитализаций больных с бронхиальной астмой и методы их коррекции. Автореферат дисс. канд. мед. наук. М., 2007.
  26. Watson L., Turk F., James P. et al. Factors associated with mortality after an asthma admiss=ion: a national United Kingdom database analysis. Respir. Med. 2007, р. 101, р. 1659-1664.
  27. Dewilde S., Turk F., Tambour M. et al. The economic value of anti-IgE in severe persistent, IgE-mediated (allergic) asthma patients: adaptation of INNOVATE to Sweden. Curr. Med. Res. Opin. 2006, v. 22, р. 1765-1776.
  28. Humbert M., Beasley R., Ayres J. et al. Benefits of omalizumab as add-on therapy in patients with severe persistent asthma who are inadequately controlled despite best available therapy (GINA 2002 step 4 treatment): INNOVATE. Allergy. 2005, v. 60, р. 309-316.
  29. GINA, Глобальная стратегия лечения и профилактики бронхиальной астмы (пересмотр 2011 г.). М.: Global Initiative for Asthma, Российское респираторное общество, 2012.
  30. Bardelas J., Figliomeni M., Kianifard F. et al. A 26-week, randomized, double-blind, placebo-controlled, multicenter study to evaluate the effect of omalizumab on asthma control in patients with persistent allergic asthma. J. Asthma. 2012, v. 49, p. 144-152.
  31. Федеральный закон от 29.12.2006 № 255-ФЗ (ред. от 03.12.2011) «Об обязательном социальном страховании на случай временной нетрудоспособности и в связи с материнством».
  32. Braman S.S. The global burden of asthma. Chest. 2006, v. 130, p. 4-12.



Abstract - 11

PDF (Russian) - 0


Article Metrics

Metrics Loading ...


Copyright (c) 2015 Russian Allergological Journal

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies