OBJECTIVES: The 2017 GOLD Report recommends triple therapy with an inhaled corticosteroid, a long acting beta2 agonist, and a long acting muscarinic antagonist for symptomatic chronic obstructive pulmonary disease (COPD) patients who continue to experience exacerbations. Multiple inhalers are currently required to administer triple therapies; posologies or device type may differ, potentially reducing adherence. A first-in-class triple fixed dose combination (FDC) containing beclomethasone dipropionate, formoterol fumarate and glycopyrronium in an extra fine formulation and a pMDI inhaler with dose counter, is indicated as maintenance treatment in adult patients with moderate to severe COPD who are not adequately treated by a combination of an inhaled corticosteroid and a long-acting beta2-agonist. This study estimates the budget impact of the new FDC therapy in the UK.

METHODS: A budget impact model was developed, using national population statistics and COPD epidemiology data to identify triple therapy eligible patients. Patients were assigned to different COPD therapies, for the “world with” and “without” triple FDC, and a five-year forecast was developed based on current and prospective potential market shares. For each therapy the associated drug acquisition cost, and rate and cost of severe (requiring hospitalization) or moderate exacerbations was applied.

RESULTS: The analysis demonstrated that the introduction of triple FDC would produce savings in each of the five years. Over this time period, depending on the level of uptake of the triple FDC (10%, 20% and 30% uptake at 5 years assessed), the net cumulative budget impact is estimated to be a saving ranging from approximately £31 to £95 million. Savings arise from displacing more expensive open triple therapies and from reducing the exacerbation rate and related costly hospitalizations.

CONCLUSIONS: The new COPD triple FDC therapy is predicted to have a positive budget impact, delivering savings through both reduced drug acquisition costs and reduced morbidity.