EVALUATING THE COST-EFFECTIVENESS OF FLUTICASONE FUROATE/UMECLIDINIUM/VILANTEROL (FF/UMEC/VI) COMPARED WITH OTHER AVAILABLE TRIPLE THERAPIES FOR THE TREATMENT OF PATIENTS WITH MODERATE-TO-SEVERE COPD IN SPAIN
Author(s)
Felipe Villar-Álvarez, MD1, Myriam Calle Rubio, MD2, Ana Hernandez, BPharm3, Alejandra Gómez Rodríguez, BPharm3, Stephen G. Noorduyn, MSc4, LAURA AMANDA VALLEJO APARICIO, MSc3.
1Pneumology Department, IIS Jiménez Díaz Foundation, Madrid, Spain, 2Department of Respiratory Medicine, Hospital Clínico San Carlos, Madrid, Spain, 3GSK, Madrid, Spain, 4Global Real-World Evidence, GSK, Mississauga, ON, Canada.
1Pneumology Department, IIS Jiménez Díaz Foundation, Madrid, Spain, 2Department of Respiratory Medicine, Hospital Clínico San Carlos, Madrid, Spain, 3GSK, Madrid, Spain, 4Global Real-World Evidence, GSK, Mississauga, ON, Canada.
OBJECTIVES: COPD management is still considered a public health challenge; maximising health and economic outcomes is therefore a priority. This analysis assessed the cost-effectiveness of once-daily fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) versus twice-daily budesonide/glycopyrronium/formoterol (BUD/GLY/FOR) and beclometasone/formoterol/glycopyrronium (BDP/FOR/GLY) for adults with moderate-to-severe COPD, from the perspective of the Spanish National Health System (SNS).
METHODS: A previously published linked-equation cohort model of COPD progression (GALAXY) was adapted to the SNS to estimate lung function, exacerbation rates, survival, associated healthcare costs, and quality-adjusted life-years (QALYs). Baseline characteristics were taken from the IMPACT trial and relative treatment effects on forced expiratory volume in 1 second (FEV₁), St George’s Respiratory Questionnaire and moderate/severe exacerbation rates were informed by a previously published frequentist network meta-analysis (Ismaila AS, et al. Adv Ther. 2022;39:3957-78). Direct medical costs (drug acquisition, disease management, and exacerbations) were sourced from Spanish-specific literature (2026 euros) and utilities were estimated via an EQ-5D regression using Spanish observational data. Deterministic and probabilistic sensitivity analyses (DSA and PSA), including price-threshold analyses, were conducted to assess uncertainty.
RESULTS: Over a 3-year time horizon, patients receiving FF/UMEC/VI gained 0.094 QALYs versus BUD/GLY/FOR and 0.052 QALYs versus BDP/FOR/GLY, together with cost savings of 1223 € and 879 € per patient, respectively, indicating that FF/UMEC/VI was a dominant option. DSA and PSA results were consistent with the base-case. Price-threshold analyses showed that BUD/GLY/FOR and BDP/FOR/GLY would require price reductions of up to 60% and 50%, respectively, to be cost-effective options.
CONCLUSIONS: Treatment with FF/UMEC/VI was a dominant option (less costly and more effective) versus BUD/GLY/FOR and BDP/FOR/GLY in patients with moderate-to-severe COPD, and remained cost-effective even when comparator prices were substantially reduced, supporting its role in maximising health and economic outcomes within the SNS. Funding: GSK (study 316841)
METHODS: A previously published linked-equation cohort model of COPD progression (GALAXY) was adapted to the SNS to estimate lung function, exacerbation rates, survival, associated healthcare costs, and quality-adjusted life-years (QALYs). Baseline characteristics were taken from the IMPACT trial and relative treatment effects on forced expiratory volume in 1 second (FEV₁), St George’s Respiratory Questionnaire and moderate/severe exacerbation rates were informed by a previously published frequentist network meta-analysis (Ismaila AS, et al. Adv Ther. 2022;39:3957-78). Direct medical costs (drug acquisition, disease management, and exacerbations) were sourced from Spanish-specific literature (2026 euros) and utilities were estimated via an EQ-5D regression using Spanish observational data. Deterministic and probabilistic sensitivity analyses (DSA and PSA), including price-threshold analyses, were conducted to assess uncertainty.
RESULTS: Over a 3-year time horizon, patients receiving FF/UMEC/VI gained 0.094 QALYs versus BUD/GLY/FOR and 0.052 QALYs versus BDP/FOR/GLY, together with cost savings of 1223 € and 879 € per patient, respectively, indicating that FF/UMEC/VI was a dominant option. DSA and PSA results were consistent with the base-case. Price-threshold analyses showed that BUD/GLY/FOR and BDP/FOR/GLY would require price reductions of up to 60% and 50%, respectively, to be cost-effective options.
CONCLUSIONS: Treatment with FF/UMEC/VI was a dominant option (less costly and more effective) versus BUD/GLY/FOR and BDP/FOR/GLY in patients with moderate-to-severe COPD, and remained cost-effective even when comparator prices were substantially reduced, supporting its role in maximising health and economic outcomes within the SNS. Funding: GSK (study 316841)
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE572
Topic
Economic Evaluation
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)