ECONOMIC EVALUATION OF SINGLE INHALER TRIPLE THERAPY FOR PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) USING THE GALAXY MODEL
Author(s)
Zhang S1, Shah D2, Risebrough N3, Martin AA4, Briggs A5, Ismaila A6
1GSK, Collegeville, PA, USA, 2ICON plc, New York, NY, USA, 3ICON plc, Toronto, ON, Canada, 4GSK, Uxbridge, UK, 5University of Glasgow, Glasgow, UK, 6GSK, Research Triangle Park, NC, USA
OBJECTIVES: FULFIL (NCT02345161) showed the clinical benefit of single inhaler, once-daily fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) 100μg/62.5μg/25μg versus twice-daily budesonide/formoterol (BUD/FOR) 400μg/12μg for patients with symptomatic COPD (Lipson, 2017). The cost-effectiveness analysis of FF/UMEC/VI versus BUD/FOR, based on FULFIL data, is reported here. METHODS: A treatment-specific adaptation of the GALAXY COPD model (Briggs, 2017) was developed to assess cost-effectiveness from the UK healthcare system perspective. The model input parameters included baseline characteristics and efficacy results from FULFIL and UK National Health Service reference cost data. Outputs included exacerbation rates, costs, life-years (LYs) gained and quality-adjusted life years (QALYs). Estimated incremental costs (ICER) per LY and per QALY gained were calculated. A discount rate of 3.5% for costs and benefits was used. Sensitivity analyses were performed on input parameters. RESULTS: The predicted cumulative number of exacerbations per patient over their lifetime was 8.26 with FF/UMEC/VI and 10.3 with BUD/FOR. The accumulated LYs (undiscounted) was 10.197 in patients who received FF/UMEC/VI and 9.43 with BUD/FOR; the accumulated QALYs were 5.36 and 4.89, respectively. The total accumulated costs over a lifetime were £20,080 with FF/UMEC/VI and £18,410 with BUD/FOR. Patients who received FF/UMEC/VI gained an additional 0.767 LYs and 0.478 QALYs compared with BUD/FOR, with an additional cost of £1,670. The ICER was £3,500 per QALY, compared with BUD/FOR. Using alternative time horizons, treatment with FF/UMEC/VI was associated with ICERs of £3,660 at 5 years and £3,300 at 10 years, per QALY, compared with BUD/FOR. Sensitivity analyses showed that variation in main parameters did not alter the results CONCLUSIONS: Based on the economic analysis, treatment with FF/UMEC/VI was predicted to reduce the total cumulative number of exacerbations, including severe events, compared with BUD/FOR. LY, QALY and cost findings suggest that FF/UMEC/VI may be a cost-effective treatment option for COPD in the UK. Funding: GSK (HO-16-13835)
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PRS38
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Respiratory-Related Disorders