OBJECTIVES: Umeclidinium/vilanterol (UMEC/VIL) and tiotropium/olodaterol (TIO/OLO), both combinations of long-acting muscarinic antagonist and long-acting beta2-adrenergic (LAMA/LABA) with similar efficacy and safety, are reimbursed for COPD treatment in Brazilian Public Healthcare System (SUS) since 2020. In 2021/2022, according to the Brazilian Government Price Panel (PP), TIO/OLO public sales volume were four times higher compared to UMEC/VIL. Our aim was to estimate the budget impact analysis (BIA) of switching TIO/OLO to UMEC/VIL for severe to very severe COPD treatment in SUS.

METHODS: Using a 5-year BIA, we evaluated the financial impact of the progressive switch from TIO/OLO to UMEC/VIL in SUS. Population eligible to be treated with LAMA/LABA was calculated using published epidemiological data. For the national estimates, a COPD prevalence of 9% in adults ≥40 years, of which 30% were diagnosed; 10.7% with severe to very severe COPD. The analyses considered a baseline market share (year 1) of 75% TIO/OLO and 25% for UMEC/VIL based on public sales percentage reported in PP for one year (November 2021 to November 2022). UMEC/VIL uptake was assumed to increase 5% each year afterwards. Costs values were presented as Brazilian Real (BRL). The price considered for both were the lowest available in PP for the period (UMEC/VIL= 82.89 BRL; TIO/OLO= 187.34 BRL).

RESULTS: Difference in treatment costs per patient per year was 1,253.40 BRL lower for UMEC/VIL. Switching eligible COPD patients for UMEC/VIL can lead to savings of 12,679,107.35 BRL in the first year, 83,330,959.85 BRL in the fifth year and 236,318,936.80 BRL accumulated in five years compared to TIO/OLO.

CONCLUSIONS: Switching to UMEC/VIL in the treatment of patients with severe to very severe COPD is predicted to be cost saving to Brazilian Public Healthcare System. Funding: GSK (220093).