OBJECTIVES : A budget impact model was developed to assess the financial impact of introducing single inhaler, once-daily fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) 100μg/62.5μg/25μg to the UK National Health Service formulary for treatment of patients with moderate to severe COPD.

METHODS : Relevant inhaled corticosteroids (ICS)/ long-acting beta agonist (LABA) and LABA/ long-acting muscarinic antagonist (LAMA) fixed-dose combinations as well as ICS/LABA + LAMA multiple inhaler triple therapies (MITTs), approved for the treatment of COPD in the UK, were considered in the analysis. An epidemiological approach leveraging local prescribing data was used with a three-year time horizon. Only drug acquisition costs (in 2017 GBP) were considered. Model outputs included the number of COPD patients treated and incremental budget impact following the introduction of FF/UMEC/VI. In the base-case, it was assumed that market share of FF/UMEC/VI would be 2%, 7% and 10% in years 1-3, respectively, 100% of which was taken from ICS/LABA + LAMA MITTs and 100% patient compliance. Sensitivity analyses were performed on input parameters.

RESULTS : Based on a conservative prevalence estimate, the number of COPD patients in the UK was 632,443, 636,573 and 640,711 in years one, two and three, respectively; with an estimated 12,649, 44,560 and 64,071 patients treated with FF/UMEC/VI. Introduction of FF/UMEC/VI to the formulary, with all market displacement coming from MITTs, would result in a cost-savings of £1,865,476, £6,571,810 and £9,449,323 in years one, two and three, respectively; resulting in the cumulative cost savings of £17,886,609. Results of one-way sensitivity analyses showed that the budget impact was most sensitive to cost (±10%) and uptake rates of FF/UMEC/VI (50% to 200%), with cost-savings over three-years ranging from £8,943,305 to £35,773,218.

CONCLUSIONS : FF/UMEC/VI has potential to reduce costs for treatment of COPD patients in the UK, if FF/UMEC/VI were to displace market share from ICS/LABA + LAMA MITTs.

Funding: GSK (HO1613835)