Cost-Effectiveness of Umeclidinium/Vilanterol (UMEC/VI) Versus Aclidinium/Formoterol (ACL/FOR) in Patients with COPD in the United Kingdom

Speaker(s)

Shah D1, Martin A2, Kendall R3, Noorduyn SG4, Dasari P5, Risebrough N6, Ismaila A7
1ICON plc, JERSEY CITY, NJ, USA, 2GSK, Brentford, UK, 3ICON plc, Langley, BC, Canada, 4Value Evidence and Outcomes, GSK, Mississauga, ON, Canada, 5ICON plc, Houston, TX, USA, 6ICON plc, Toronto, ON, Canada, 7Value Evidence and Outcomes, GSK, Collegeville, PA, USA

Presentation Documents

OBJECTIVES: To assess the cost-effectiveness of once-daily umeclidinium/vilanterol (UMEC/VI) 62.5/25 mcg versus twice-daily aclidinium/formoterol (ACL/FOR) 400/12 mcg for the treatment of chronic obstructive pulmonary disease (COPD), from a United Kingdom (UK) National Healthcare System (NHS) perspective.

METHODS:

A validated linked risk equation model (GALAXY; Briggs, 2017 Med Decis Making 37:4), which predicts COPD disease progression, healthcare costs, and health outcomes, was populated with baseline characteristics from a clinical trial conducted in patients eligible for dual therapy (NCT02799784; Feldman, 2017 Adv Ther 34:2518–-2533). Treatment effects included change from baseline (CFB) in forced expiratory volume in 1 second (FEV1), CFB in St George’s Respiratory Questionnaire (SGRQ), and reduction in exacerbations. Efficacy estimates were derived using 24-week results from a frequentist network meta-analysis (Ismaila, 2022 Adv Ther 39(11):4961–5010).

Model outputs included estimated exacerbation rates, costs, life-years (LYs), and quality-adjusted LYs (QALYs); incremental cost-effectiveness ratio (ICER) was calculated for cost per QALY gained. Healthcare resource use, drug costs, and unit costs (£, 2022) were derived from UK public sources and the published literature. Costs and health outcomes (except LYs) were discounted at 3.5% per year over a lifetime horizon. One-way sensitivity analyses were conducted on efficacy inputs. Scenario analyses were conducted varying time horizon, discount rate, and baseline characteristics, and included discontinuation rates, patient productivity costs, and rescue medication use.

RESULTS: UMEC/VI provided an additional 0.608 LYs (95% confidence interval: 0.283, 0.942) and 0.291 QALYs (0.088, 0.503), with cost savings of £3,555 (£2,682, £4,585) compared with ACL/FOR. Across all scenario and sensitivity analyses, UMEC/VI was consistently dominant versus ACL/FOR.

CONCLUSIONS:

In a UK NHS setting, treatment with UMEC/VI was predicted to improve health outcomes and be the dominant (lower costs and better outcomes) treatment option compared with ACL/FOR in patients with symptomatic COPD.

Code

EE708

Topic

Economic Evaluation

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis

Disease

No Additional Disease & Conditions/Specialized Treatment Areas, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)