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Cost-Effectiveness Of Once-Daily Single-Inhaler Triple Therapy In COPD: The IMPACT Trial.

Afisi S Ismaila1,2, Nancy Risebrough3, Melanie Schroeder4

  • 1Value Evidence and Outcomes, GlaxoSmithKline plc, Collegeville, PA, USA.

International Journal of Chronic Obstructive Pulmonary Disease
|December 11, 2019
PubMed
Summary
This summary is machine-generated.

Single-inhaler fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) is a cost-effective option for COPD patients in Canada. It reduces exacerbations and improves life years and QALYs compared to other treatments.

Keywords:
Canadachronic obstructive pulmonary diseasecost-effectivenessquality-adjusted life yearssingle-inhaler triple therapy

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Area of Science:

  • Pulmonary Medicine
  • Health Economics
  • Pharmacoeconomics

Background:

  • Chronic obstructive pulmonary disease (COPD) poses a significant burden on healthcare systems.
  • Managing COPD exacerbations is crucial for improving patient outcomes and reducing healthcare costs.
  • Current treatment guidelines recommend inhaled therapies for symptomatic COPD patients with a history of exacerbations.

Purpose of the Study:

  • To assess the cost-effectiveness of a single-inhaler triple therapy (fluticasone furoate/umeclidinium/vilanterol [FF/UMEC/VI]) compared to dual therapies (FF/VI or UMEC/VI) in Canada.
  • To evaluate the long-term clinical and economic impact of FF/UMEC/VI in a Canadian public healthcare setting.
  • To determine if FF/UMEC/VI represents a value-for-money intervention for COPD management.

Main Methods:

  • A validated GALAXY-COPD disease progression model was used, incorporating data from the IMPACT trial (NCT02164513).
  • Canadian unit and drug costs (2017) were applied to healthcare resource utilization and treatments.
  • Probabilistic analyses were conducted, with future costs and outcomes discounted at 1.5% annually, measuring exacerbation rates, costs, life years (LYs), and quality-adjusted life years (QALYs).

Main Results:

  • FF/UMEC/VI demonstrated fewer moderate and severe exacerbations, more LYs, and more QALYs gained compared to FF/VI and UMEC/VI over a lifetime horizon.
  • The incremental cost-effectiveness ratio (ICER) per QALY gained was C$18,989 versus FF/VI and C$13,776 versus UMEC/VI.
  • FF/UMEC/VI remained cost-effective across all sensitivity and scenario analyses, including variations in discontinuation and subsequent treatment effects.

Conclusions:

  • FF/UMEC/VI is predicted to improve clinical outcomes for symptomatic COPD patients with a history of exacerbations.
  • The single-inhaler triple therapy is a cost-effective treatment option within the Canadian healthcare system.
  • These findings support the adoption of FF/UMEC/VI for optimizing COPD management and resource allocation.