COST-UTILITY ANALYSIS OF BUDESONIDE/GLYCOPYRROLATE/FORMOTEROL FUMARATE VERSUS FLUTICASONE FUROATE/UMECLIDINIUM/VILANTEROL FOR MODERATE-TO-VERY SEVERE COPD IN CHINA
Author(s)
Ke Huang, PhD1, Powei Wu, MSc2, Wangyang Zhao, PhD3, Krishnali Parsekar, MSc4, Deniz Tansey-Dwyer, MSc5, Jianwei Xuan, PhD3.
1Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China, 2Health Economics Research Institute, School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou, China, 3Health Economics Research Institute, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China, 4Health Economics & Payer Evidence, BioPharmaceuticals R&I, AstraZeneca, Cambridge, United Kingdom, 5Pricing & Market Access, BioPharmaceuticals R&I, AstraZeneca, Cambridge, United Kingdom.
1Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China, 2Health Economics Research Institute, School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou, China, 3Health Economics Research Institute, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China, 4Health Economics & Payer Evidence, BioPharmaceuticals R&I, AstraZeneca, Cambridge, United Kingdom, 5Pricing & Market Access, BioPharmaceuticals R&I, AstraZeneca, Cambridge, United Kingdom.
OBJECTIVES: This study evaluated the cost-effectiveness of the single-inhaler triple therapy budesonide/glycopyrrolate/formoterol fumarate (BGF) compared with fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) for patients with moderate-to-very severe chronic obstructive pulmonary disease (COPD) from the perspective of the Chinese healthcare system.
METHODS: A global semi-Markov cohort model was adapted to the Chinese setting with a 1-year time horizon. Clinical efficacy inputs utilized a matching-adjusted indirect comparison (MAIC) of the ETHOS and IMPACT trials, incorporating a significant all-cause mortality reduction with BGF (HR=0.61). To accurately reflect local clinical practice, healthcare resource utilization and unit costs—specifically for disease management, acute exacerbations, and end-of-life care—were derived from a multi-center China real-world evidence (RWE) database (records from 2019 onwards) and validated by a panel of Chinese clinical experts. Costs and health outcomes were discounted at 5% annually.
RESULTS: Over a 1-year time horizon, BGF was a dominant treatment strategy compared with FF/UMEC/VI, yielding lower total costs (incremental savings: ¥354 per patient) and improved health outcomes (+0.002 QALYs; +0.003 Life Years). Economic savings were primarily driven by a substantial reduction in end-of-life costs (-¥250), which fully offset the increased disease management costs (+¥30). Probabilistic sensitivity analysis confirmed these findings. Deterministic sensitivity analysis demonstrated model robustness, showing BGF remained cost-saving across all parameter variations, with treatment discontinuation rates identified as influential factors.
CONCLUSIONS: BGF represents a cost-saving and more effective therapeutic option for moderate-to-very severe COPD in China versus FF/UMEC/VI. By integrating local RWE and accounting for survival benefits, this study demonstrates that BGF’s clinical advantages translate into considerable economic value, supporting its prioritization in Chinese payer policy decision-making.
METHODS: A global semi-Markov cohort model was adapted to the Chinese setting with a 1-year time horizon. Clinical efficacy inputs utilized a matching-adjusted indirect comparison (MAIC) of the ETHOS and IMPACT trials, incorporating a significant all-cause mortality reduction with BGF (HR=0.61). To accurately reflect local clinical practice, healthcare resource utilization and unit costs—specifically for disease management, acute exacerbations, and end-of-life care—were derived from a multi-center China real-world evidence (RWE) database (records from 2019 onwards) and validated by a panel of Chinese clinical experts. Costs and health outcomes were discounted at 5% annually.
RESULTS: Over a 1-year time horizon, BGF was a dominant treatment strategy compared with FF/UMEC/VI, yielding lower total costs (incremental savings: ¥354 per patient) and improved health outcomes (+0.002 QALYs; +0.003 Life Years). Economic savings were primarily driven by a substantial reduction in end-of-life costs (-¥250), which fully offset the increased disease management costs (+¥30). Probabilistic sensitivity analysis confirmed these findings. Deterministic sensitivity analysis demonstrated model robustness, showing BGF remained cost-saving across all parameter variations, with treatment discontinuation rates identified as influential factors.
CONCLUSIONS: BGF represents a cost-saving and more effective therapeutic option for moderate-to-very severe COPD in China versus FF/UMEC/VI. By integrating local RWE and accounting for survival benefits, this study demonstrates that BGF’s clinical advantages translate into considerable economic value, supporting its prioritization in Chinese payer policy decision-making.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE286
Topic
Economic Evaluation
Disease
SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)