OBJECTIVES

: Chronic Obstructive Pulmonary Disease (COPD) is a frequent respiratory disease. The goals of COPD assessment include the determination of future exacerbations risk. The combination of inhaled corticosteroid + long-acting beta agonist, such as budesonide/formoterol, is recommended for those patients with a higher risk of exacerbations. The aim of this analysis was to evaluate the costs of budesonide/formoterol when used for patients with COPD in Mexico.

METHODS

: A cost analysis was performed to evaluate the difference in treatment of moderate to severe COPD with budesonide/formoterol vs salmeterol/fluticasone from the perspective of Seguro Popular, one of the main public health insurance systems in Mexico. A time horizon of 1 year was considered. The efficacy measure was the reduction in exacerbations and pneumonia events obtained from the PATHOS study.Only direct medical costs were included, comprising drug acquisition, and exacerbations’ management consisting of emergency visits, hospitalizations, oral steroid use and treatment of pneumonia. All costs are expressed in 2017 US dollars.

RESULTS

: Budesonide/formoterol was associated with a lower annual rate of exacerbations compared to salmeterol/fluticasone (0.8 vs 1.09, p<0.0001). The analysis showed that budesonide/formoterol reduced the costs associated with the management of exacerbations by 37% compared to salmeterol/fluticasone, mainly due to the lower annual rate of COPD-related hospitalizations and pneumonia events. When considering all costs, budesonide/formoterol added up to USD$768.86 and salmeterol/fluticasone USD$1,104.25, providing yearly cost savings per patient equivalent to USD$335.39 (31%). When translating these results to the population covered by Seguro Popular, it’s budget could be reduced by USD$166 million.

CONCLUSIONS

: Utilising data from the PATHOS study, this analysis showed that budesonide/formoterol significantly reduces the number of exacerbations in patients with COPD, resulting in lower costs for the treatment of moderate to severe COPD in Mexico when compared to salmeterol/fluticasone, generating savings in the budget of Seguro Popular.