Introduction: One in 20 deaths were from Chronic Obstructive Pulmonary Disease (COPD) in 2015. The TONADO 1 and 2 studies demonstrated that Tiotropium-Olodaterol significantly improved lung function and symptoms compared to monocomponents.

Objective: To estimate the budget impact of incorporating Tiotropium-Olodaterol for COPD in the Chilean public healthcare system.

Methods: Budget Impact Analysis following the ISPOR 6-step approach. A Markov model of 2-health and 1-transition states was used for a 5-year horizon (one-year cycle). Direct costs (CLP) were estimated from national open-access databases and Diagnosis-Related Groups data. The simulated scenario modeled the incorporation of Tiotropium-Olodaterol for a proportion of cases based on their GOLD subgroup, considering its addition into the pool of existent standard of care (SoC) drugs in GOLD C and D subgroups, and its effect on exacerbations requiring outpatient and inpatient services.

Results: The inclusion of Tiotropium-Olodaterol results in 45,340 avoided exacerbations over a 5-year horizon. The most significant effects were observed in GOLD D, for whom, based on local medical prescription behavior, would receive the drug in a proportion of 90%, compared to 70% in GOLD C. The total cost of including Tiotropium-Olodaterol to SoC at five years reaches CLP$ 78,7 million in GOLD C patients and CLP$ 300,0 million in GOLD D (including emergency care for exacerbations, costs of adverse reactions, and hospitalizations needs). After five years, the incremental cost of this therapy is CLP$ -5,2 million (-1.4%), representing savings for the payer. After five years, an annual incremental cost per patient was estimated at CLP$ -15,645.

Conclusions: The effect on the rate of exacerbations offsets the higher costs of Tiotropium-Olodaterol, and it is the variable with the greatest impact on the analysis. The use of Tiotropium-Olodaterol would be related to savings for the Chilean public health system.