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Evaluación económica de la terapia triple con un solo inhalador para la enfermedad pulmonar obstructiva crónica en

Piyameth Dilokthornsakul¹, Piyawat Dilokthornsakul^2,3, Bunchai Chongmelaxme⁴

¹Center for Medical and Health Technology Assessment (CM-HTA), Department of Pharmaceutical Care, Chiang Mai University, Chiang Mai, Thailand.

BMJ open respiratory research

|February 12, 2026

Resumen

La terapia triple de inhalador único (SITT) no es actualmente rentable para la EPOC en Tailandia en comparación con la terapia triple de inhalador múltiple (MITT). Una reducción del precio del 30% para el fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) podría convertirlo en una opción de tratamiento de la EPOC rentable.

Área de la Ciencia:

Economía de la salud Economía de la salud
Farmacoeconomía La farmacoeconomía es la economía de las drogas.
Medicina de las vías respiratorias Medicina de las vías respiratorias

Sus antecedentes:

La terapia triple de inhalador único (SITT) es rentable para la EPOC en los países occidentales.
Falta evidencia de la rentabilidad de SITT en entornos de recursos limitados como Tailandia.

Objetivo del estudio:

Evaluar la relación costo-utilidad del SITT en comparación con la terapia triple con inhaladores múltiples (MITT) para pacientes con EPOC en Tailandia.
Evaluar la viabilidad económica de SITT en un sistema de salud con recursos limitados.

Principales métodos:

Se utilizó un modelo de Markov de horizonte de vida desde una perspectiva social.
Se compararon dos regímenes SITT (FF/UMEC/VI y BUD/GLY/FOR) con el MITT (SAL/FP+TIO).
Se calcularon los años de vida ajustados por calidad (QALY) y los coeficientes incrementales de rentabilidad (ICER).

Principales resultados:

FF/UMEC/VI mostró una mejora marginal de QALY pero con un alto ICER (1.899.408 THB/QALY).
BUD/GLY/FOR estaba dominado, ofreciendo QALYs más bajos y costos más altos que MITT.
FF/UMEC/VI tenía sólo un 1,1% de posibilidades de ser rentable en el umbral de 160.000 THB.

Conclusiones:

Los precios actuales de SITT no los hacen rentables para el tratamiento de la EPOC en Tailandia en comparación con MITT.
El fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) podría hacerse rentable con una reducción de precios de ~30%.

Palabras clave:

Epidemiología de la EPOC Economista de la salud Economista de la salud.

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