A UNITED STATES BUDGET IMPACT ANALYSIS OF BUDESONIDE/GLYCOPYRROLATE/FORMOTEROL FUMARATE IN THE TREATMENT OF INADEQUATELY CONTROLLED ASTHMA
Author(s)
William Vincent Padula, PhD1, Hayley Drew Germack, MS, RN, PhD2, Kathleen Walpole, -2, Elayne Schmidt, BS2, Chris Edmonds, -3, Krishnali Pareskar, MSc4, Benjamin Cohen, MPH, PhD5.
1University of Southern California, Los Angeles, CA, USA, 2AstraZeneca, Wilmington, DE, USA, 3ASTRAZENECA, Gaithersburg, MD, USA, 4AstraZeneca, Cambridge, United Kingdom, 5Stage Analytics, Suwanee, GA, USA.
1University of Southern California, Los Angeles, CA, USA, 2AstraZeneca, Wilmington, DE, USA, 3ASTRAZENECA, Gaithersburg, MD, USA, 4AstraZeneca, Cambridge, United Kingdom, 5Stage Analytics, Suwanee, GA, USA.
OBJECTIVES: Asthma imposes substantial clinical and economic burdens on over 26 million patients in the United States (U.S.), including those receiving medium- or high-dose inhaled corticosteroid/long-acting β2-agonist therapy whose disease remains uncontrolled. Single-inhaler triple therapies with a long-acting muscarinic antagonist offer important clinical benefits, yet comparative economic evaluations are limited. A budget impact model (BIM) was developed to estimate the financial implications of introducing budesonide/glycopyrrolate/formoterol fumarate (BUD/GLY/FORM) compared with fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) for patients advancing to triple therapy from a U.S. payer perspective.
METHODS: The BIM was constructed over a 3-year time horizon in 2025 U.S. dollars for a hypothetical 1,000,000-member health plan. Epidemiological data informed the number of eligible adult patients with uncontrolled asthma. The model compared two scenarios: (1) without BUD/GLY/FORM, in which FF/UMEC/VI 100/62.5/25 μg (43%) and 200/62.5/25 μg (57%) comprised the treatment mix; and (2) with 50% assumed uptake of BUD/GLY/FORM 320/36/9.6 μg, evenly displacing FF/UMEC/VI dosages. An indirect treatment comparison synthesized trial data to inform severe exacerbation rates (CAPTAIN for FF/UMEC/VI; KALOS/LOGOS for BUD/GLY/FORM) and the distribution of exacerbation-related utilization. Cost components included maintenance inhaler therapy and exacerbation-related emergency department visits, hospitalizations, and corticosteroid use. Outputs were incremental annual total and per member per month (PMPM) costs.
RESULTS: Including BUD/GLY/FORM was associated with net budget savings of $1,008,470 each year ($3,025,410 cumulative) for a 1,000,000-member plan, corresponding to PMPM changes of -$0.08 (-$0.24 cumulative). Each year, 344 fewer severe exacerbations occurred, 297 involving oral corticosteroids, 23 requiring an emergency department visit, and 24 resulting in hospitalization, corresponding to roughly 100 bed days avoided. BUD/GLY/FORM’s introduction reduced maintenance inhaler spending by $490,613 each year.
CONCLUSIONS: Adding BUD/GLY/FORM led to PMPM savings alongside fewer severe exacerbations and lower exacerbation-related utilization and spending. BUD/GLY/FORM may be a valuable option for payers prioritizing exacerbation prevention in uncontrolled asthma.
METHODS: The BIM was constructed over a 3-year time horizon in 2025 U.S. dollars for a hypothetical 1,000,000-member health plan. Epidemiological data informed the number of eligible adult patients with uncontrolled asthma. The model compared two scenarios: (1) without BUD/GLY/FORM, in which FF/UMEC/VI 100/62.5/25 μg (43%) and 200/62.5/25 μg (57%) comprised the treatment mix; and (2) with 50% assumed uptake of BUD/GLY/FORM 320/36/9.6 μg, evenly displacing FF/UMEC/VI dosages. An indirect treatment comparison synthesized trial data to inform severe exacerbation rates (CAPTAIN for FF/UMEC/VI; KALOS/LOGOS for BUD/GLY/FORM) and the distribution of exacerbation-related utilization. Cost components included maintenance inhaler therapy and exacerbation-related emergency department visits, hospitalizations, and corticosteroid use. Outputs were incremental annual total and per member per month (PMPM) costs.
RESULTS: Including BUD/GLY/FORM was associated with net budget savings of $1,008,470 each year ($3,025,410 cumulative) for a 1,000,000-member plan, corresponding to PMPM changes of -$0.08 (-$0.24 cumulative). Each year, 344 fewer severe exacerbations occurred, 297 involving oral corticosteroids, 23 requiring an emergency department visit, and 24 resulting in hospitalization, corresponding to roughly 100 bed days avoided. BUD/GLY/FORM’s introduction reduced maintenance inhaler spending by $490,613 each year.
CONCLUSIONS: Adding BUD/GLY/FORM led to PMPM savings alongside fewer severe exacerbations and lower exacerbation-related utilization and spending. BUD/GLY/FORM may be a valuable option for payers prioritizing exacerbation prevention in uncontrolled asthma.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE287
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)