Cost-Utility Analysis of Single-Inhaler Indacaterol Acetate/Glycopyrronium Bromide/Mometasone Furoate for Maintenance Therapy in Patients With Moderate-to-Severe Uncontrolled Asthma in China

Speaker(s)

Chen Y1, Jiang Q2, Qiu J3, Huang H2, Hu H2, Xuan J4, Zhang Q2
1Office of Drug Clinical Trial Institution, the Third Affiliated Hospital, Southern Medical University, Guangzhou, 44, China, 2Office of Drug Clinical Trial Institution, the Third Affiliated Hospital, Southern Medical University, Guangzhou, Guangdong, China, 3School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, 44, China, 4Health Economic Research Institute, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, China

Presentation Documents

OBJECTIVES: Indacaterol acetate/glycopyrronium bromide/mometasone furoate (IND/GLY/MF) is currently the only triple inhalation therapy approved for asthma indication in China and has demonstrated favorable clinical outcomes in Phase III trials. This study aims to evaluate the cost-effectiveness of IND/GLY/MF compared to salmeterol/fluticasone+tiotropium bromide (SAL/FLU+TIO) and SAL/FLU, respectively, for the treatment of adult patients with uncontrolled moderate-to-severe asthma.

METHODS: A Markov model was constructed from the perspective of the Chinese healthcare system, encompassing four states: no asthma exacerbation, mild-to-moderate acute exacerbation, severe acute exacerbation, and death. Patients with mild to moderate acute exacerbations are assumed to self-manage to relieve acute asthma exacerbations. Severe acute exacerbations are further divided into three sub-states based on subsequent treatment measures: outpatient, ED visit, and hospitalization. The model cycle was two weeks, and the time horizon was the patient's lifetime. The primary outcomes were quality-adjusted life years (QALYs), costs, and the incremental cost-effectiveness ratio (ICER). Exacerbation rates were derived from ARGON and IRIDIUM clinical trials. Mortality rates, costs, and utility values were sourced from public databases and published literature. One-way and probabilistic sensitivity analyses were conducted to assess the uncertainty of input parameters.

RESULTS: Compared to SAL/FLU+TIO, IND/GLY/MF had lower costs (¥90,519.57 vs. ¥200,964.51) and higher QALYs (15.04 QALYs vs. 14.14 QALYs), demonstrating absolute dominance. Compared to SAL/FLU, IND/GLY/MF had higher costs (¥91,547.21 vs. ¥89,348.86) but higher QALYs (14.50 QALYs) vs. 12.34 QALYs), with an ICER of ¥1,015/QALY. IND/GLY/MF was cost-effective at the willingness-to-pay threshold of ¥89,358/QALY (1x China's GPD per capita). The base case results in sensitivity analysis were robust to all assumptions and parameter changes.

CONCLUSIONS: The single-inhaler IND/GLY/MF offered better clinical efficacy and was considered cost-effective with increased QALY gain for the maintenance therapy in Chinese patients with moderate-to-severe uncontrolled asthma.

Code

EE756

Topic

Economic Evaluation

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis

Disease

Drugs, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)