Economic Impact of the Introduction of Combined Triple Therapy Budesonide/Glycopyrronium/Formoterol in the Continuous Treatment of Chronic Obstructive Pulmonary Disease in Algeria

OBJECTIVES: Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of death worldwide. For severe cases, a triple combination therapy (TCT) with a long-acting β2 agonist (LABA), an inhaled corticosteroid (ICS), and an antimuscarinic (LAMA) is recommended. This study aims to evaluate the economic impact of introducing the TCT in the continuous treatment of moderate to severe COPD in adults in Algeria.

METHODS: A Budget Impact Analysis (BIA) was conducted from the payer’s perspective over a 5-year time horizon. The study population included patients with moderate to severe COPD not controlled with a combination BALA/AMLA or BALA/CSI at the pulmonary department of University Hospital of Beni Messous. The model compared annual costs of acquisition, monitoring, and management of exacerbations for each treatment in each scenario. In Scenario 1 (without TCT): the treatments considered in this model are those already registered, marketed, and reimbursed in Algeria until 2023. In scenario 2 (with TCT): a portion of study population is placed on TCT with a reallocation of market shares. (50% TCT the first year and 10% annual increase in TCT adoption the following four years).

RESULTS: Over the five years, the number of patients eligible for TCT is estimated at 5,125 patients. In Scenario 1, 4,014 patients would be treated with open triple therapy (OTT). In Scenario 2; 989 patients would be treated with OTT, while 3,604 patients would be treated with TCT. The remaining patients would stay on dual therapy. With a cost of € 2,436.21 per patient per year, the scenario including TCT results in a reduction of the budgetary impact by € 12,624.51 for 3604 patients treated over a 5-year time horizon. This reduction is directly related to the decreased rate exacerbations.

CONCLUSIONS: COPD imposes a heavy economic burden. Combined triple therapy could reduce this burden by decreasing exacerbations and improving adherence.