Economic Analysis of New Single-Inhaler Triple Therapies in Patients with COPD in the UK.

IF 3.1 3区医学 Q2 RESPIRATORY SYSTEM

International Journal of Chronic Obstructive Pulmonary Disease Pub Date : 2025-08-07 eCollection Date: 2025-01-01 DOI:10.2147/COPD.S475748

Rui Cai, Alan A Martin, Yuchen Ge, Nancy A Risebrough, Katrin Haeussler, Christopher Compton, David M G Halpin, Afisi S Ismaila

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引用次数: 0

Abstract

Purpose: Chronic obstructive pulmonary disease (COPD) is associated with a substantial economic burden in the UK. Although previous analyses have compared the cost-effectiveness of single-inhaler triple therapy (SITT) versus dual therapy or multiple-inhaler triple therapy, there are no studies investigating the cost-effectiveness of individual SITTs versus other SITTs. This study assessed the cost-effectiveness of SITT with fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) versus other SITTs for the treatment of COPD from a UK National Health Service perspective.

Patients and methods: The validated GALAXY-COPD model was populated with patient baseline characteristics from the IMPACT study and treatment effect data from a network meta-analysis, which compared FF/UMEC/VI with budesonide/glycopyrrolate/formoterol fumarate (BUD/GLY/FOR; both 320 µg and 160 µg dosing; BUD320 and BUD160, respectively) and beclometasone dipropionate/formoterol fumarate/glycopyrrolate (BDP/FOR/GLY). UK healthcare resource unit and drug costs (Great British Pound, 2022) were applied, with costs and outcomes (except life years [LYs]) discounted at 3.5% annually. The base case was probabilistic (5000 iterations) with a lifetime horizon.

Results: FF/UMEC/VI provided an additional 0.620 (95% range: 0.255, 1.025) LYs and 0.283 (0.080, 0.501) quality-adjusted LYs (QALYs) with a cost saving of £1620 (£158, £3243) versus BUD320/GLY/FOR, an additional 0.627 (0.261, 1.053) LYs and 0.309 (0.097, 0.533) QALYs at a cost saving of £1721 (£261, £3345) versus BUD160/GLY/FOR, and an additional 0.328 (0.063, 0.654) LYs and 0.230 (0.035, 0.437) QALYs at a cost saving of £1221 (-£541, £2796) versus BDP/FOR/GLY. FF/UMEC/VI was less costly and showed higher QALYs in 98.2%, 98.9%, and 93.6% of simulations versus BUD360/GLY/FOR, BUD160/GLY/FOR, and BDP/FOR/GLY, respectively. At a willingness-to-pay threshold of £20,000 per QALY, the probability of FF/UMEC/VI being cost-effective was 99.9%, 100%, and 99.3% versus BUD320/GLY/FOR, BUD160/GLY/FOR, and BDP/FOR/GLY, respectively.

Conclusion: Based on this analysis, FF/UMEC/VI is a dominant (improved outcomes with cost savings) treatment option compared with other SITTs for the treatment of patients with COPD in the UK.

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英国COPD患者新的单吸入器三联疗法的经济分析

目的：在英国，慢性阻塞性肺疾病（COPD）与巨大的经济负担相关。虽然以前的分析比较了单吸入器三联治疗（SITT）与双重治疗或多重吸入器三联治疗的成本效益，但没有研究调查单个SITT与其他SITT的成本效益。本研究从英国国民健康服务的角度评估了SITT联合糠酸氟替卡松/乌莫替尼/维兰特罗（FF/UMEC/VI）与其他SITT治疗COPD的成本效益。患者和方法：验证的GALAXY-COPD模型填充了来自IMPACT研究的患者基线特征和来自网络荟萃分析的治疗效果数据，该分析将FF/UMEC/VI与布地奈德/甘罗罗酸酯/富马酸福莫特罗(BUD/GLY/FOR；320µg和160µg剂量；BUD320和BUD160)和二丙酸倍氯米松/富马酸福莫特罗/甘罗酸酯（BDP/FOR/GLY）。采用英国医疗资源单位和药品成本（2022年英镑），成本和结果（生命年[LYs]除外）每年按3.5%折现。基本情况是具有生命周期的概率性（5000次迭代）。结果：FF/UMEC/VI提供了额外的0.620(95%范围：0.255,1.025)LYs和0.283（0.080,0.501）质量调整LYs (QALYs)，与BUD320/GLY/FOR相比，成本节省1620英镑（158英镑，3243英镑）；与BUD160/GLY/FOR相比，额外的0.627 (0.261,1.053)LYs和0.309 (0.097,0.533)QALYs，成本节省1721英镑（261英镑，3345英镑）；与BDP/FOR/GLY相比，额外的0.328 (0.063,0.654)LYs和0.230 (0.035,0.437)QALYs，成本节省1221英镑（- 541英镑，2796英镑）。与BUD360/GLY/FOR、BUD160/GLY/FOR和BDP/FOR/GLY相比，FF/UMEC/VI的模拟成本更低，质量ys更高，分别为98.2%、98.9%和93.6%。在每个QALY的支付意愿阈值为20,000英镑时，FF/UMEC/VI的成本效益概率分别为99.9%，100%和99.3%，而BUD320/GLY/FOR， BUD160/GLY/FOR和BDP/FOR/GLY。结论：基于这一分析，FF/UMEC/VI与其他sitt相比是英国COPD患者的主要治疗选择（改善结果并节省成本）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Chronic Obstructive Pulmonary Disease RESPIRATORY SYSTEM-

CiteScore

4.80

自引率

10.70%

发文量

372

审稿时长

16 weeks

期刊介绍： An international, peer-reviewed journal of therapeutics and pharmacology focusing on concise rapid reporting of clinical studies and reviews in COPD. Special focus will be given to the pathophysiological processes underlying the disease, intervention programs, patient focused education, and self management protocols. This journal is directed at specialists and healthcare professionals