OBJECTIVES : Assess the cost-effectiveness of the combination between Fluticasone Furoate, Umeclidinium and Vilanterol (FF/UMEC/VI) in a one single-inhalator against two dual combination (FF/VI and UMEC/VI) and one combination of Fluticasone Propionate 250mg/Salmeterol 25mg and tiotropium 18mcg (FP/SAL + TIO) in patients with COPD moderate to very-severe

METHODS : A risk-equation model (GALAXY model) was adapted to represent the natural history of disease, and to estimate the economic and health benefits. The expected costs were measured in Chilean pesos (USD$1= CLP$702.63) and health benefits in quality adjusted life years (QALYs). The QALYs were estimated mapping the values obtained by the Saint-George Respiratory Questionnaire (SGRQ-C) to EQ-5D. A lifetime horizon and 3% discount rate were considered for cost and benefits. A probabilistic sensibility analysis was performed to account for second order uncertainty.

RESULTS : The total expected costs of treating the COPD moderate to very-severe with Trelegyâ were higher than FF/VI and FP/SAL+TIO (incremental cost Trelegy vs FF/VI: $1298; vs FP/SAL+TIO: $1016). Nonetheless, Trelegy was less expensive than UMEC/VI (incremental cost Trelegy vs UMEC/VI: -$47.9). The estimated QALYs for Trelegy were the highest. The base case scenario shows an ICER for Trelegy vs FF/VI and vs FP/SAL+TIO of $10,178.9 and $50,801.6/QALY, respectively, whilst UMEC/VI was dominated by Trelegy. At suggested threshold of $14,943.8 (1xGDP per capita in Chile), the CEAC shows that Trelegy has an 98%, 100% and 48% to be a cost-effectiveness alternative in comparison with FF/VI, UMEC/VI and FP/SAL+TIO.

CONCLUSIONS : Trelegy has showed to be a cost-effectiveness alternative to treat the COPD moderate to very severe, producing more health benefits and even saving costs in some cases.