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Cost-Effectiveness Of Once-Daily Single-Inhaler Triple Therapy In COPD: The IMPACT Trial
- Source :
- International Journal of Chronic Obstructive Pulmonary Disease. 14:2681-2695
- Publication Year :
- 2019
- Publisher :
- Informa UK Limited, 2019.
-
Abstract
- Background We assessed the cost-effectiveness of single-inhaler fluticasone furoate (FF)/umeclidinium (UMEC)/vilanterol (VI) versus FF/VI or UMEC/VI from a Canadian public healthcare perspective, incorporating data from the IMPACT trial in chronic obstructive pulmonary disease (COPD) (NCT02164513). Methods Baseline inputs and treatment effects from IMPACT were populated into the validated GALAXY-COPD disease progression model. Canadian unit costs and drug costs (Canadian dollars [C$], 2017) were applied to healthcare resource utilization and treatments. Future costs and health outcomes were discounted at 1.5% annually. Analyses were probabilistic, and outputs included exacerbation rates, costs, and life years (LYs) and quality-adjusted life years (QALYs) gained. Results Compared with FF/VI and UMEC/VI over a lifetime horizon, the analyses predicted that treatment with FF/UMEC/VI resulted in fewer moderate and severe exacerbations, more LYs and more QALYs gained, with a small incremental cost. The base-case incremental cost-effectiveness ratio (ICER) per QALY gained was C$18,989 (95% confidence interval [CI]: C$14,665, C$25,753) versus FF/VI and C$13,776 (95% CI: C$9787, C$19,448) versus UMEC/VI. FF/UMEC/VI remained cost-effective versus both FF/VI and UMEC/VI in all sensitivity analyses, including in scenario analyses that considered different intervention and comparator discontinuation rates, and treatment effects for subsequent therapy. Conclusion Treatment with FF/UMEC/VI was predicted to improve outcomes and be a cost-effective treatment option for patients with symptomatic COPD and a history of exacerbations compared with FF/VI or UMEC/VI, in Canada.
- Subjects :
- medicine.medical_specialty
COPD
Exacerbation
Cost effectiveness
business.industry
General Medicine
medicine.disease
Fluticasone propionate
Confidence interval
Quality-adjusted life year
Discontinuation
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
030228 respiratory system
chemistry
Internal medicine
medicine
030212 general & internal medicine
Vilanterol
business
health care economics and organizations
medicine.drug
Subjects
Details
- ISSN :
- 11782005
- Volume :
- 14
- Database :
- OpenAIRE
- Journal :
- International Journal of Chronic Obstructive Pulmonary Disease
- Accession number :
- edsair.doi...........ea0978f9a11fb5d3b766ffa4526270f3