OBJECTIVES: Since 2021, open triple therapy with LABA/LAMA + ICS are reimbursed for COPD treatment in Brazilian Public Healthcare System (SUS). These therapies are withdrawn at different dispensing points with multiple inhalers, which can contribute to increased chance of errors. This study aims to determine budget impact of close triple therapy (single inhaler) with fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) in SUS.

METHODS: Using a 5-year budget impact analysis (BIA), we evaluated the financial impact of the progressive switch from multiple inhalers triple therapy available at SUS (LABA/LAMA = tiotropium/olodaterol (TIO/OLO) or umeclidinium/vilanterol (UMEC/VI) plus ICS = budesonide (BUD) or beclomethasone (BECL)) to single inhaler triple therapy with FF/UMEC/VI. Population eligible was calculated using published epidemiological data, COPD prevalence of 9% in adults ≥40 years, of which 30% were diagnosed; 2.86% with severe to very severe (GOLD 3 and 4) and exacerbation and symptoms profile (Group D). For reference scenario was considered a baseline market share for LABA/LAMA (year 1) of 53% TIO/OLO and 47% UMEC/VI based on percentage reported in DATASUS for 2022. For ICS, BUD 200 mcg 62%, BUD 400 mcg 32%, and BECL 200 mcg 6% of total purchases according to public database price (BPS). For projected scenario, was assumed 21% migrated to FF/UMEC/VI in the first year, considering better dosing comfort and an uptake 7% in the upcoming years. Costs values were presented as Brazilian Real (BRL). The price considered for comparators were volume weighted average available in BPS.

RESULTS: Switching eligible COPD patients to FF/UMEC/VI can lead to savings of 13 million BRL in first year, 32 million BRL in fifth year and 112 million BRL accumulated in five years compared to open triple therapy.

CONCLUSIONS: This study suggests a better allocation of resources with equivalent therapeutic gain paralleled with adherence benefits for eligible patients with COPD.