The present analyses was performed to estimate the effect of cilomilast on chronic obstructive pulmonary disease (COPD) patients’ relative risk (RR) of improvement/deterioration in quality of life (QOL) and non-drug medical costs.METHOD: The analyses was based on a randomized, double blind, placebo-controlled study, which evaluated cilomilast (15 mg twice daily) in patients with COPD. Patients’ QOL was measured using the St. George’s Respiratory Questionnaire (SGRQ), a disease-specific QOL questionnaire. The RR estimates for QOL improvement/deterioration were determined based on study results. The healthcare utilization data on physician office visits, emergency department visits, and hospitalizations were collected during the trial.
A total of 536 patients (cilomilast = 340, placebo = 196) were included in the analyses. A greater proportion of patients achieved a clinically meaningful QOL improvement in the cilomilast group as compared to placebo (47.6% vs. 31.6%, respectively) resulting in a significant RR of QOL improvement of 1.51 (95% CI: 1.21 to 1.88). A greater proportion of patients experienced clinically relevant deterioration in their QOL in the placebo group as compared to cilomilast (39.3% vs. 22.9%, respectively) resulting in a significant RR of QOL deterioration of 0.58 (95% CI: 0.45 to 0.76). Moreover, the non-drug medical cost per patient for the 24-week treatment period was significantly lower in the cilomilast group ($12.06, 95% CI: $3.85 to $27.89) as compared to placebo group ($97.79, 95% CI: $35.37 to $176.24).CONCLUSIONS: Patients in cilomilast group were 1.5 times more likely to experience a clinically meaningful improvement in their QOL and about 40 % less likely to experience a clinically relevant deterioration in their QOL as compared placebo. Patients in the cilomilast group also experienced significant cost reductions in terms of their non-drug medical costs as compared to placebo.
COPD patients on cilomilast are more likely to experience QOL improvement and less likely to experience QOL deterioration at significantly lower non-drug medical costs as compared to placebo.
R.D. Borker, Employee - GlaxoSmithKline, Industry.