OBJECTIVES: An Excel-based model was developed to assess the budget impact of budesonide/glycopyrrolate/formoterol fumarate (BGF) for treatment of moderate to very severe chronic obstructive pulmonary disease (COPD) vs. other dual- or triple-combination inhaled therapies.

METHODS: Moderate to very severe COPD patients were modeled from a United States payer perspective; impacts were calculated as cost differences between scenarios with and without BGF. Epidemiological data, treatment parameters, exacerbation rates and market share data were sourced from BGF trial publications, comparator prescribing information, published literature and market sales data. Comparators include existing single-inhaled triple combination (FF/UMEC/VIL), open triple combinations (class level), and dual combinations (i.e. ICS/LABA and LABA/LAMA; class level). Results are reported as total direct savings, per treated patient per month (PPPM) and per patient per month (PMPM); total ‘societal’ savings were also calculated for Medicare assuming ‘Part-D only’ member volume where medical savings may not be directly realized by the plan.

RESULTS: For a 1M member fully-insured commercial plan, eligible moderate to very severe COPD patients was 59,995 in year-1 increasing to 69,202 by year-3 . Estimated 3-year direct cost savings from adding BGF to formulary totaled $1.35M ($0.59 PPPM; $0.04 PMPM). The total direct cost associated with BGF over the full period was estimated to be $65.4M (6.2% of total pharmacy spend for maintenance combinations). For a 1M member Medicare plan (94,699 eligible COPD patients by year-3) direct total savings for the plan were $511,633 ($0.15 PPPM; $0.01 PMPM). Societal savings accounting for all avoided medical events totaled $5.81M for the Medicare plan.

CONCLUSIONS: This model suggests that adding BGF as a treatment option for COPD can result in budget savings for both fully-insured and Medicare plans with Part-D only patients. Savings were largely explained by prevented exacerbation events and reduced pharmacy costs compared to open triple combinations.