COST UTILITY ANALYSIS OF BUDESONIDE/GLYCOPYRROLATE/FORMOTEROL FUMARATE VERSUS FLUTICASONE FUROATE/UMECLIDINIUM/VILANTEROL FOR MODERATE TO VERY SEVERE COPD: A COLOMBIAN PAYER PERSPECTIVE
Author(s)
Camilo Tamayo, BA1, Andre Verhoek, MSc2, Lotte Westerink, MSc3, Carlos Chacon, MD4, Deniz Tansey-Dwyer, MSc5, Efraín Esteban, MD4.
1Market Access, Astrazeneca, Bogotá, Colombia, 2Global Pricing & Market Access, BioPharmaceuticals R&I, Astrazeneca, Barcelona, Spain, 3Health Economics and Payer Evidence, BioPharmaceuticals R&I, Astrazeneca, Cambridge, United Kingdom, 4Medical Affairs, Astrazeneca, Bogotá, Colombia, 5Pricing & Market Access, BioPharmaceuticals R&I, Astrazeneca, Cambridge, United Kingdom.
1Market Access, Astrazeneca, Bogotá, Colombia, 2Global Pricing & Market Access, BioPharmaceuticals R&I, Astrazeneca, Barcelona, Spain, 3Health Economics and Payer Evidence, BioPharmaceuticals R&I, Astrazeneca, Cambridge, United Kingdom, 4Medical Affairs, Astrazeneca, Bogotá, Colombia, 5Pricing & Market Access, BioPharmaceuticals R&I, Astrazeneca, Cambridge, United Kingdom.
OBJECTIVES: Triple fixed dose inhaled combinations are recommended for patients with moderate to very severe chronic obstructive pulmonary disease (COPD) who remain symptomatic or experience frequent exacerbations. This study aimed to evaluate the cost utility of budesonide/glycopyrrolate/formoterol fumarate (BGF) compared with fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI), adapting a previously published economic model to the Colombian healthcare system and payer perspective.
METHODS: A global semi-Markov cohort model was adapted to the Colombian setting over a 5-year time horizon. Clinical efficacy inputs were informed by a matching-adjusted indirect comparison (MAIC) of the ETHOS and IMPACT trials, incorporating a significant all-cause mortality reduction with BGF (HR=0.61). Resource use and unit costs were sourced from Colombian tariff manuals and publicly available datasets. Outcomes included costs, life‑years (Lys), and quality-adjusted life-years (QALYs). Costs were calculated in Colombian pesos (COP) and subsequently converted to US dollars. Both costs and outcomes were discounted at 5% annually. Parameter uncertainty was assessed using probabilistic sensitivity analysis.
RESULTS: Over a 5-year horizon, BGF was associated with a modest increase in total costs and improved clinical outcomes compared with FF/UMEC/VI. Incremental costs were USD 124.51 per patient, with gains of 0.174 QALYs and 0.304 life-years (LYs). Higher costs were primarily driven by increased survival and related treatment and disease management costs (USD 323.67), partially offset by lower end-of-life costs (-USD 199.16). The resulting ICER was USD 716.64 per QALY gained. This ICER is well below commonly used willingness-to-pay (WTP) thresholds in Colombia, including 0.86 GDP per capita for 2025 (USD 7,409) and 1 GDP per capita (USD 8,616). Probabilistic sensitivity analysis confirmed the robustness of these results.
CONCLUSIONS: BGF is a cost-effective therapeutic option for moderate-to-very severe COPD in Colombia compared with FF/UMEC/VI. These findings suggest that the clinical benefits if BGF, particularly improved survival, translate into economic favourable outcomes, supporting its consideration in Colombian payer decision‑making.
METHODS: A global semi-Markov cohort model was adapted to the Colombian setting over a 5-year time horizon. Clinical efficacy inputs were informed by a matching-adjusted indirect comparison (MAIC) of the ETHOS and IMPACT trials, incorporating a significant all-cause mortality reduction with BGF (HR=0.61). Resource use and unit costs were sourced from Colombian tariff manuals and publicly available datasets. Outcomes included costs, life‑years (Lys), and quality-adjusted life-years (QALYs). Costs were calculated in Colombian pesos (COP) and subsequently converted to US dollars. Both costs and outcomes were discounted at 5% annually. Parameter uncertainty was assessed using probabilistic sensitivity analysis.
RESULTS: Over a 5-year horizon, BGF was associated with a modest increase in total costs and improved clinical outcomes compared with FF/UMEC/VI. Incremental costs were USD 124.51 per patient, with gains of 0.174 QALYs and 0.304 life-years (LYs). Higher costs were primarily driven by increased survival and related treatment and disease management costs (USD 323.67), partially offset by lower end-of-life costs (-USD 199.16). The resulting ICER was USD 716.64 per QALY gained. This ICER is well below commonly used willingness-to-pay (WTP) thresholds in Colombia, including 0.86 GDP per capita for 2025 (USD 7,409) and 1 GDP per capita (USD 8,616). Probabilistic sensitivity analysis confirmed the robustness of these results.
CONCLUSIONS: BGF is a cost-effective therapeutic option for moderate-to-very severe COPD in Colombia compared with FF/UMEC/VI. These findings suggest that the clinical benefits if BGF, particularly improved survival, translate into economic favourable outcomes, supporting its consideration in Colombian payer decision‑making.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE573
Topic
Economic Evaluation, Health Technology Assessment
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)