
Chronic obstructive pulmonary disease (COPD) is associated with a substantial economic burden in the UK. Although previous analyses have compared the cost-effectiveness of single-inhaler triple therapy (SITT) versus dual therapy or multiple-inhaler triple therapy, there are no studies investigating the cost-effectiveness of individual SITTs versus other SITTs. This study assessed the cost-effectiveness of SITT with fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) versus other SITTs for the treatment of COPD from a UK National Health Service perspective.The validated GALAXY-COPD model was populated with patient baseline characteristics from the IMPACT study and treatment effect data from a network meta-analysis, which compared FF/UMEC/VI with budesonide/glycopyrrolate/formoterol fumarate (BUD/GLY/FOR; both 320 µg and 160 µg dosing; BUD320 and BUD160, respectively) and beclometasone dipropionate/formoterol fumarate/glycopyrrolate (BDP/FOR/GLY). UK healthcare resource unit and drug costs (Great British Pound, 2022) were applied, with costs and outcomes (except life years [LYs]) discounted at 3.5% annually. The base case was probabilistic (5000 iterations) with a lifetime horizon.FF/UMEC/VI provided an additional 0.620 (95% range: 0.255, 1.025) LYs and 0.283 (0.080, 0.501) quality-adjusted LYs (QALYs) with a cost saving of £1620 (£158, £3243) versus BUD320/GLY/FOR, an additional 0.627 (0.261, 1.053) LYs and 0.309 (0.097, 0.533) QALYs at a cost saving of £1721 (£261, £3345) versus BUD160/GLY/FOR, and an additional 0.328 (0.063, 0.654) LYs and 0.230 (0.035, 0.437) QALYs at a cost saving of £1221 (-£541, £2796) versus BDP/FOR/GLY. FF/UMEC/VI was less costly and showed higher QALYs in 98.2%, 98.9%, and 93.6% of simulations versus BUD360/GLY/FOR, BUD160/GLY/FOR, and BDP/FOR/GLY, respectively. At a willingness-to-pay threshold of £20,000 per QALY, the probability of FF/UMEC/VI being cost-effective was 99.9%, 100%, and 99.3% versus BUD320/GLY/FOR, BUD160/GLY/FOR, and BDP/FOR/GLY, respectively.Based on this analysis, FF/UMEC/VI is a dominant (improved outcomes with cost savings) treatment option compared with other SITTs for the treatment of patients with COPD in the UK.
Male, Quinuclidines, Cost-Benefit Analysis, Nebulizers and Vaporizers, Muscarinic Antagonists, International Journal of Chronic Obstructive Pulmonary Disease, Chlorobenzenes, United Kingdom, Drug Costs, Bronchodilator Agents, Pulmonary Disease, Chronic Obstructive, Drug Combinations, Treatment Outcome, Models, Economic, Administration, Inhalation, Humans, Female, Quality-Adjusted Life Years, Adrenergic beta-2 Receptor Agonists, Benzyl Alcohols, Original Research, Aged
Male, Quinuclidines, Cost-Benefit Analysis, Nebulizers and Vaporizers, Muscarinic Antagonists, International Journal of Chronic Obstructive Pulmonary Disease, Chlorobenzenes, United Kingdom, Drug Costs, Bronchodilator Agents, Pulmonary Disease, Chronic Obstructive, Drug Combinations, Treatment Outcome, Models, Economic, Administration, Inhalation, Humans, Female, Quality-Adjusted Life Years, Adrenergic beta-2 Receptor Agonists, Benzyl Alcohols, Original Research, Aged
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