COST-UTILITY ANALYSIS OF FLUTICASONE FUROATE/UMECLIDINIUM/VILANTEROL COMPARED WITH VILANTEROL/UMECLIDINIUM FOR THE REDUCTION OF MODERATE TO SEVERE EXACERBATIONS IN THE TREATMENT OF MODERATE TO VERY SEVERE CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN...
Author(s)
Christian A. Lopez-Castillo, MD, MBA1, Jessika Arguello, Pharm.Chem.1, Sergio Basto, Pharm.Chem., MSc1, Olga Milena Garcia-Morales, MD, MSc2, Pablo Ramón Gil-Torres, MD3, MARIA CARRASQUILLA SOTOMAYOR, BEc, MSc4;
1Universidad de Antioquia, Medellin, Colombia, 2Fundación Santafé de Bogotá, Bogotá, Colombia, 3Fundación Neumológica Colombiana, Bogotá, Colombia, 4Universidade do São Paulo, São Paulo, Brazil
1Universidad de Antioquia, Medellin, Colombia, 2Fundación Santafé de Bogotá, Bogotá, Colombia, 3Fundación Neumológica Colombiana, Bogotá, Colombia, 4Universidade do São Paulo, São Paulo, Brazil
OBJECTIVES: Chronic Obstructive Pulmonary Disease (COPD) represents a significant health and economic impact in Colombia. This study aimed to evaluate the cost-utility of Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI) compared to Umeclidinium/Vilanterol (UMEC/VI) for reducing moderate and severe exacerbations in patients with moderate to very severe COPD from Colombian health system perspective.
METHODS: A Markov model was developed with two health states: stable disease (SD) and death, and two transient events: Moderate and Severe Exacerbations. A 1,000-patient cohort was simulated, over a lifetime horizon. Outcomes were reported in quality-adjusted life years (QALYs). A 5% annual discount rate (DR) was applied to costs and health outcomes. Probabilities were derived from the IMPACT study. Direct healthcare costs were estimated through top-down microcosting. Costs were given in Colombian Pesos (COP). A willingness-to-pay (WTP) threshold of 0.86 GDP per capita (COP $27,830,928.86) was used.
RESULTS: FF/UMEC/VI was more costly and more effective than UMEC/VI, with an ICER of $21,137,682.97 per QALY, below the cost-effectiveness threshold. The net monetary benefit (NMB) was higher for FF/UMEC/VI ($130.5 million vs. $62.6 million). ICER was sensitive to Stable Disease, Severe Exacerbations and FF/UMEC/VI costs and QALYs of Severe Exacerbations. FF/UMEC/VI remained cost-effective through TDs (0%, 3.5%, 7%, 12%). Probabilistic analysis yielded an ICER of $8.373.495,44/QALY. FF/UMEC/VI was cost-effective in 100% of simulations.
CONCLUSIONS: FF/UMEC/VI is a cost-effective treatment strategy compared to UMEC/VI for reducing moderate and severe exacerbations in moderate to very severe COPD in Colombia. Results were robust across sensitivity analyses, although sensitive to certain cost variations confirming the favorable economic profile of FF/UMEC/VI within the Colombian healthcare context.
METHODS: A Markov model was developed with two health states: stable disease (SD) and death, and two transient events: Moderate and Severe Exacerbations. A 1,000-patient cohort was simulated, over a lifetime horizon. Outcomes were reported in quality-adjusted life years (QALYs). A 5% annual discount rate (DR) was applied to costs and health outcomes. Probabilities were derived from the IMPACT study. Direct healthcare costs were estimated through top-down microcosting. Costs were given in Colombian Pesos (COP). A willingness-to-pay (WTP) threshold of 0.86 GDP per capita (COP $27,830,928.86) was used.
RESULTS: FF/UMEC/VI was more costly and more effective than UMEC/VI, with an ICER of $21,137,682.97 per QALY, below the cost-effectiveness threshold. The net monetary benefit (NMB) was higher for FF/UMEC/VI ($130.5 million vs. $62.6 million). ICER was sensitive to Stable Disease, Severe Exacerbations and FF/UMEC/VI costs and QALYs of Severe Exacerbations. FF/UMEC/VI remained cost-effective through TDs (0%, 3.5%, 7%, 12%). Probabilistic analysis yielded an ICER of $8.373.495,44/QALY. FF/UMEC/VI was cost-effective in 100% of simulations.
CONCLUSIONS: FF/UMEC/VI is a cost-effective treatment strategy compared to UMEC/VI for reducing moderate and severe exacerbations in moderate to very severe COPD in Colombia. Results were robust across sensitivity analyses, although sensitive to certain cost variations confirming the favorable economic profile of FF/UMEC/VI within the Colombian healthcare context.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE391
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)