EVALUATING THE IMPACT AND VALUE OF EARLIER SINGLE INHALER TRIPLE THERAPY (SITT) INITIATION IN COPD MANAGEMENT IN ARGENTINA, COLOMBIA AND VIETNAM: A COST-UTILITY MODELING STUDY
Author(s)
Danny Gibson, BSc, MASc1, S Gando, PhD2, A Kobrin, PhD2, Kiet Pham Huy Tuan, PhD3, Vu Van Giap, PhD4, C Aguirre, PhD5, R Benavides, PhD6, Ezzat Hamza, PhD7, Suzan Serip, Phd8, Lise Retat, PhD9.
1Health Economist, AstraZeneca, Sheffield, United Kingdom, 2STNBA, Buenos Aires, Argentina, 3Hanoi Medical University, Ha Noi, Viet Nam, 4Bach Mai Hospital, Hannoi, Viet Nam, 5Fundación Neumológica Colombiana, Bogota, Colombia, 6Universidad Pontificia Bolivariana, Medellin, Colombia, 7AstraZeneca, Dubai, United Arab Emirates, 8AstraZeneca, Madrid, Spain, 9AstraZeneca, Barcelona, Spain.
1Health Economist, AstraZeneca, Sheffield, United Kingdom, 2STNBA, Buenos Aires, Argentina, 3Hanoi Medical University, Ha Noi, Viet Nam, 4Bach Mai Hospital, Hannoi, Viet Nam, 5Fundación Neumológica Colombiana, Bogota, Colombia, 6Universidad Pontificia Bolivariana, Medellin, Colombia, 7AstraZeneca, Dubai, United Arab Emirates, 8AstraZeneca, Madrid, Spain, 9AstraZeneca, Barcelona, Spain.
OBJECTIVES: To assess the clinical and economic impact of earlier initiation of Single Inhaler Triple Therapy (SITT) following a qualifying COPD exacerbation in Argentina, Colombia and Vietnam, compared with delayed initiation (current clinical practice). The analysis aimed to quantify effects on exacerbations, costs from a national health care system perspective and quality-adjusted life years (QALYs), and to translate evidence into policy-relevant value messages.
METHODS: A health economic model was developed to compare guideline-directed medical therapy (GDMT) with prompt SITT initiation at hospital discharge after either a second moderate or first severe exacerbation, versus delayed SITT initiation (base case: 6 months delay). Clinical inputs were informed by the published PRIMUS study, and by published literature. The model captured COPD-related exacerbations, cardiovascular (CV) events, mortality, health care resource utilisation (hospitalisations, emergency visits, general ward bed-days) and costs. Outcomes included costs, clinical events, QALYs, and life-years over a 12-month horizon, with extensions explored in sensitivity analyses.
RESULTS: Preliminary base-case results suggest earlier SITT initiation is cost-saving in all three countries. In Argentina, Colombia and Vietnam, treatment acquisition costs were approximately 10%, 10%, 9% higher but were offset by a 24.7%, 19.6%, 22.5% reduction in exacerbation-related costs and a 6.9%, 8.1%, 5.0% reduction in CV-related costs. Clinical benefits included fewer exacerbations, reduced hospitalizations and associated bed-days and gains in health outcomes, with QALYs increasing by 10%, 10.7%, 9.7%. Scenario analyses varying the delay duration were directionally consistent, with greater delays associated with higher exacerbation rates
CONCLUSIONS: For patients with COPD experiencing a qualifying exacerbation, prompt SITT initiation at discharge is associated with improved health outcomes and reduce overall costs compared with delayed initiation. The results support adherence to GDMT with earlier SITT initiation as a policy-relevant strategy is likely cost-effective and potentially cost-saving in Argentina, Colombia and Vietnam.
METHODS: A health economic model was developed to compare guideline-directed medical therapy (GDMT) with prompt SITT initiation at hospital discharge after either a second moderate or first severe exacerbation, versus delayed SITT initiation (base case: 6 months delay). Clinical inputs were informed by the published PRIMUS study, and by published literature. The model captured COPD-related exacerbations, cardiovascular (CV) events, mortality, health care resource utilisation (hospitalisations, emergency visits, general ward bed-days) and costs. Outcomes included costs, clinical events, QALYs, and life-years over a 12-month horizon, with extensions explored in sensitivity analyses.
RESULTS: Preliminary base-case results suggest earlier SITT initiation is cost-saving in all three countries. In Argentina, Colombia and Vietnam, treatment acquisition costs were approximately 10%, 10%, 9% higher but were offset by a 24.7%, 19.6%, 22.5% reduction in exacerbation-related costs and a 6.9%, 8.1%, 5.0% reduction in CV-related costs. Clinical benefits included fewer exacerbations, reduced hospitalizations and associated bed-days and gains in health outcomes, with QALYs increasing by 10%, 10.7%, 9.7%. Scenario analyses varying the delay duration were directionally consistent, with greater delays associated with higher exacerbation rates
CONCLUSIONS: For patients with COPD experiencing a qualifying exacerbation, prompt SITT initiation at discharge is associated with improved health outcomes and reduce overall costs compared with delayed initiation. The results support adherence to GDMT with earlier SITT initiation as a policy-relevant strategy is likely cost-effective and potentially cost-saving in Argentina, Colombia and Vietnam.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HSD17
Topic
Economic Evaluation, Health Policy & Regulatory, Health Service Delivery & Process of Care
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)