P250 Informing the pathway of COPD treatment (the IMPACT study): single inhaler triple therapy (FF/UMEC/VI) versus FF/VI in patients with COPD – cost-effectiveness in the UK

Martin, Agnès; Shah, Drishti; Schroeder, Maik; Ndirangu, Kerigo; Risebrough, N; Anley, Glenn A; Okorogheye, Gabriel; Fenwick, Elisabeth; Ismaila, AS

doi:10.1136/thorax-2018-212555.406

Cited by 3 publications

(5 citation statements)

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“…Consistent with the findings of our study, a similar costeffectiveness analysis conducted in the United Kingdom (UK), which used the GALAXY model to compare FF/ UMEC/VI with BUD/FOR based on FULFIL and using UK unit costs, demonstrated that FF/UMEC/VI SITT was also cost-effective vs dual therapy in the UK. 45 Using data from the InforMing the PAthway of COPD Treatment (IMPACT) trial (NCT02164513), 14 two further studies have also demonstrated the cost-effectiveness of FF/UMEC/VI vs another ICS/ LABA combination (FF/VI) 46 and LAMA/LABA dual therapy (UMEC/VI). 47 These findings suggest that the data on cost-effectiveness in the UK and Spain may extend to other countries.…”

Section: Discussionmentioning

confidence: 99%

<p>Cost-Effectiveness Analysis of a Once-Daily Single-Inhaler Triple Therapy for Patients with Chronic Obstructive Pulmonary Disease (COPD) Using the FULFIL Trial: A Spanish Perspective</p>

Schroeder¹,

Benjamin²,

Atienza³

et al. 2020

COPD

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Purpose: To evaluate the cost-effectiveness of once-daily fluticasone furoate/umeclidinium/ vilanterol (FF/UMEC/VI) vs twice-daily budesonide/formoterol (BUD/FOR) in patients with symptomatic chronic obstructive pulmonary disease (COPD) at risk of exacerbations, from the Spanish National Healthcare System perspective. Patients and Methods: The validated GALAXY-COPD model was used to simulate disease progression and predict healthcare costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) over a 3-year time horizon for a Spanish population. Patient characteristics from published literature were supplemented by data from FULFIL (NCT02345161), which compared FF/UMEC/VI vs BUD/FOR in patients with symptomatic COPD at risk of exacerbations. Treatment effects, extrapolated to 3 years, were based on Week 24 results in the FULFIL intent-to-treat population, including change in forced expiratory volume in 1 second, St. George's Respiratory Questionnaire score, and exacerbation rates. Treatment, exacerbations, and COPD management costs (2019€) were informed by Spanish public sources and published literature. A 3% discount rate for costs and benefits was applied. One-way sensitivity and scenario analyses, and probabilistic sensitivity analysis (PSA), were performed. Results: FF/UMEC/VI treatment led to fewer moderate and severe exacerbations (2.126 and 0.306, respectively) vs BUD/FOR (2.608 and 0.515, respectively), with a mean incremental cost of €69 and gain of 0.107 QALYs, which resulted in an ICER of €642 per QALY gained. In sensitivity analyses, the ICER was most sensitive to treatment effect variations in exacerbations and healthcare resource utilization/event costs. Overall, 95% of 1000 PSA simulations resulted in an ICER less than €11,000 per QALY gained for FF/UMEC/VI vs BUD/FOR, confirming robustness of the results. The probability of FF/UMEC/VI being cost-effective vs BUD/FOR was 100% at a willingness-to-pay threshold of €30,000 per QALY gained. Conclusion: At the accepted Spanish ICER threshold of €30,000, FF/UMEC/VI represents a cost-effective treatment option vs BUD/FOR in patients with symptomatic COPD at risk of exacerbations.

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Section: Discussionmentioning

confidence: 99%

<p>Cost-Effectiveness Analysis of a Once-Daily Single-Inhaler Triple Therapy for Patients with Chronic Obstructive Pulmonary Disease (COPD) Using the FULFIL Trial: A Spanish Perspective</p>

Schroeder¹,

Benjamin²,

Atienza³

et al. 2020

COPD

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“…Markov models have been widely used in the economic assessment of COPD treatment, 15 , 16 , 38–44 and the overall strengths of this modeling approach merited its selection in the current analysis. The health state structure aims to capture stages in COPD progression that represent differences in healthcare costs and patient health-related QoL, and costs and health-related QoL decrements associated with moderate and severe exacerbations are captured.…”

Section: Discussionmentioning

confidence: 99%

“…Markov models have been widely used in the economic assessment of COPD treatment, 15,16,[38][39][40][41][42][43][44] and the overall strengths of this modeling approach merited its selection in the current analysis. The health state structure aims to capture Notes: COPD health states were defined by lung function, as determined by FEV 1 .…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

“…Using data from the IMPACT study, ICS/LAMA/LABA triple therapy with fluticasone furoate/umeclidinium/ vilanterol (FF/UMEC/VI) was shown to be cost-effective versus ICS/LABA therapy with FF/VI in patients with symptomatic COPD and a history of exacerbations in the UK. 15 In a separate analysis using data from the IMPACT study, FF/UMEC/VI was also demonstrated to be cost-effective versus LAMA/LABA therapy with UMEC/VI in the UK. 16 The 52-week ETHOS study (NCT02465567) showed that triple therapy with a budesonide/glycopyrronium/formoterol fumarate dihydrate (BGF) metered-dose inhaler at two ICS dose levels (320/14.4/10 μg and 160/14.4/10 μg) reduced moderate or severe COPD exacerbations versus fixed-dose LAMA/LABA or ICS/LABA dual therapy in patients with moderate-to-very severe COPD and at least one exacerbation in the previous year.…”

Section: Introductionmentioning

confidence: 98%

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Cost-Effectiveness of Triple Therapy with Budesonide/Glycopyrronium/Formoterol Fumarate Dihydrate versus Dual Therapies in Moderate-to-Very Severe Chronic Obstructive Pulmonary Disease: United Kingdom Analysis Using the ETHOS Study

Nigris¹,

Treharne²,

Brighton³

et al. 2022

COPD

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Background In the 52-week ETHOS study (NCT02465567), fixed-dose triple therapy with budesonide/glycopyrronium/formoterol fumarate dihydrate (BGF) reduced moderate or severe chronic obstructive pulmonary disease (COPD) exacerbations versus fixed-dose long-acting muscarinic antagonist (LAMA)/long-acting β 2 -agonist (LABA) or inhaled corticosteroid (ICS)/LABA dual therapies. Here, ETHOS data were used to estimate the long-term cost-effectiveness of BGF versus LAMA/LABA and ICS/LABA dual therapies in the United Kingdom. Methods Costs, exacerbations, quality-adjusted life-years (QALYs), and LYs were extrapolated using a Markov model that considered disease severity progression, risk of moderate and severe exacerbations, adverse events, and treatment discontinuation in patients with moderate-to-very severe COPD receiving BGF 320/14.4/10 µg, the LAMA/LABA glycopyrronium/formoterol fumarate dihydrate 14.4/10 µg (GFF), or the ICS/LABA budesonide/formoterol fumarate dihydrate 320/10 µg (BFF). Utilities for COPD severity states were estimated using EuroQol 5-dimension 5-level data from ETHOS. Exacerbation disutilities were sourced from published literature. Healthcare resource utilization was based on ETHOS data, published literature, key external experts’ input, and informed assumptions. Unit costs came from the UK National Health Service Schedule of Reference Costs, Unit Costs of Health and Social Care from the Personal Social Services Research Unit, and published literature. A lifetime horizon was considered, with costs, QALYs, and LYs discounted at 3.5% per annum. Results The incremental cost–utility ratio (ICUR; per QALY gained) was £9901 for BGF versus GFF and £2164 for BGF versus BFF. The probability of treatments being cost-effective at the conventional UK-adopted willingness-to-pay threshold of ICUR <£20,000 was 85.1% for BGF, 14.3% for GFF, and 0.6% for BFF. Conclusion Based on ETHOS data, BGF was demonstrated to be cost-effective versus LAMA/LABA and ICS/LABA dual therapies at the conventional UK-adopted willingness-to-pay threshold (ICUR <£20,000). The main cost-effectiveness driver for BGF versus LAMA/LABA and ICS/LABA therapies was reduction in rate of exacerbations, which reduced costs and preserved quality of life.

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Cost-effectiveness of triple therapy with budesonide/glycopyrronium/formoterol fumarate dihydrate compared with dual therapy for the treatment of chronic obstructive pulmonary disease (COPD) in Canada

Johnston,

Shephard,

Friesen

et al. 2023

Canadian Journal of Respiratory, Critical Care, and Sleep Medic

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P250 Informing the pathway of COPD treatment (the IMPACT study): single inhaler triple therapy (FF/UMEC/VI) versus FF/VI in patients with COPD – cost-effectiveness in the UK

Cited by 3 publications

References 0 publications

<p>Cost-Effectiveness Analysis of a Once-Daily Single-Inhaler Triple Therapy for Patients with Chronic Obstructive Pulmonary Disease (COPD) Using the FULFIL Trial: A Spanish Perspective</p>

<p>Cost-Effectiveness Analysis of a Once-Daily Single-Inhaler Triple Therapy for Patients with Chronic Obstructive Pulmonary Disease (COPD) Using the FULFIL Trial: A Spanish Perspective</p>

Cost-Effectiveness of Triple Therapy with Budesonide/Glycopyrronium/Formoterol Fumarate Dihydrate versus Dual Therapies in Moderate-to-Very Severe Chronic Obstructive Pulmonary Disease: United Kingdom Analysis Using the ETHOS Study

Cost-effectiveness of triple therapy with budesonide/glycopyrronium/formoterol fumarate dihydrate compared with dual therapy for the treatment of chronic obstructive pulmonary disease (COPD) in Canada

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