Cost-Effectiveness of Umeclidinium/Vilanterol Combination Therapy for Group B COPD Patients
Author(s)
Tananan Rattanachotphanit, PhD1, Noppakun Thammatacharee, PhD2, Chulaporn Limwattananon, PhD3, Supon Limwattananon, PhD4, Onanong Waleekhachonloet, PhD1;
1Mahasarakham University, Mahasarakham, Thailand, 2Health Systems Research Institute, Nonthaburi, Thailand, 3Independent Researcher, Khon Kaen, Thailand, 4International Health Policy Foundation, Nonthaburi, Thailand
1Mahasarakham University, Mahasarakham, Thailand, 2Health Systems Research Institute, Nonthaburi, Thailand, 3Independent Researcher, Khon Kaen, Thailand, 4International Health Policy Foundation, Nonthaburi, Thailand
OBJECTIVES: Thailand is striving to improve clinical outcomes for chronic obstructive pulmonary disease (COPD) by reducing exacerbations, hospitalizations, and mortality through the increased use of inhaled medications. However, the combination of a long-acting muscarinic antagonist (LAMA) and a long-acting beta2 agonist (LABA), recommended in the 2023 Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines for Group B COPD patients, has not been included in the National List of Essential Medicines (NLEM). This study aimed to evaluate the cost-effectiveness of umeclidinium/vilanterol (UMEC/VI) compared to tiotropium (TIO) monotherapy for Group B COPD patients in Thailand.
METHODS: The study compared lifetime costs (in 2024 US$) and quality-adjusted life years (QALYs) across treatment options using a Markov model that incorporated both the GOLD classification for COPD based on the ABCD assessment tool and severity stages according to airflow limitation. A network meta-analysis (NMA) was conducted to assess the effectiveness of treatments. COPD progression was modeled based on forced expiratory volume in one second (FEV1) and the annual rate of FEV1 decline of the Thai patients. Costs were based on hospital and claim data, while utility scores were derived from St George’s Respiratory Questionnaire total score (SGRQ) scores from 281 Thai COPD patients.
RESULTS: From a societal perspective, UMEC/VI provided a gain of 0.25 QALYs compared to TIO monotherapy. The incremental costs associated with UMEC/VI was US$1743, resulting in incremental cost-effectiveness ratios (ICERs) of US$7020 per QALY which exceeded the willingness-to-pay (WTP) threshold established for Thailand. UMEC /VI would be cost-effective if its price were reduced by 16%.
CONCLUSIONS: The results demonstrated the feasibility of UMEC/VI aligning with Thailand’s WTP threshold and being included in the NLEM through price negotiation, thereby increasing access to necessary medicine and subsequently improving clinical outcomes for Group B COPD patients.
METHODS: The study compared lifetime costs (in 2024 US$) and quality-adjusted life years (QALYs) across treatment options using a Markov model that incorporated both the GOLD classification for COPD based on the ABCD assessment tool and severity stages according to airflow limitation. A network meta-analysis (NMA) was conducted to assess the effectiveness of treatments. COPD progression was modeled based on forced expiratory volume in one second (FEV1) and the annual rate of FEV1 decline of the Thai patients. Costs were based on hospital and claim data, while utility scores were derived from St George’s Respiratory Questionnaire total score (SGRQ) scores from 281 Thai COPD patients.
RESULTS: From a societal perspective, UMEC/VI provided a gain of 0.25 QALYs compared to TIO monotherapy. The incremental costs associated with UMEC/VI was US$1743, resulting in incremental cost-effectiveness ratios (ICERs) of US$7020 per QALY which exceeded the willingness-to-pay (WTP) threshold established for Thailand. UMEC /VI would be cost-effective if its price were reduced by 16%.
CONCLUSIONS: The results demonstrated the feasibility of UMEC/VI aligning with Thailand’s WTP threshold and being included in the NLEM through price negotiation, thereby increasing access to necessary medicine and subsequently improving clinical outcomes for Group B COPD patients.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE393
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)