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Cost-effectiveness of umeclidinium as add-on to ICS/LABA therapy in COPD: A UK perspective.
Respir Med 2018; 145:130-137RM

Abstract

INTRODUCTION

The cost-effectiveness of long-acting muscarinic antagonist (LAMA) umeclidinium bromide (UMEC) 62.5 μg as add-on therapy to other maintenance COPD treatments is unknown.

METHODS

This analysis assessed the cost-effectiveness of the following in COPD: UMEC + fluticasone furoate/vilanterol 100/25 μg (FF/VI); UMEC + fluticasone propionate/salmeterol 250/50 μg (FP/SAL); and UMEC + several alternative choices of inhaled corticosteroid/long-acting β2-agonist (ICS/LABA). The model was informed with direct and indirect data from previously published studies, with a UK perspective and a lifetime horizon. Sensitivity analyses were also performed.

RESULTS

For the lifetime horizon, compared with FF/VI, FP/SAL and ICS/LABAs, addition of UMEC was associated with incremental costs per quality-adjusted life-years (QALY) of £4050, £7210 and £5780, respectively, and incremental costs per life year gain of £3380, £6020 and £4940. All UMEC-containing regimens resulted in numerically lower exacerbation rates versus comparator regimens over a lifetime horizon.

CONCLUSIONS

Addition of UMEC to various ICS/LABA treatments was associated with higher cost than ICS/LABA alone, but was cost-effective in most scenarios.

Authors+Show Affiliations

Value Evidence & Outcomes, GSK, Brentford, Middlesex, UK. Electronic address: m.t.driessen@gmail.com.ICON Health Economics, ICON, NY, USA. Electronic address: Dhvani.Shah@iconplc.com.ICON Health Economics, ICON, Toronto, Canada. Electronic address: Nancy.Risebrough@iconplc.com.ICON Health Economics, ICON, NY, USA. Electronic address: Timothy.Baker@iconplc.com.Respiratory Medical Franchise, GSK, Brentford, Middlesex, UK. Electronic address: ian.p.naya@gsk.com.Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK. Electronic address: andrew.briggs@glasgow.ac.uk.Value Evidence & Outcomes, GSK, Research Triangle Park, NC, USA; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada. Electronic address: afisi.s.ismaila@gsk.com.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30509701

Citation

Driessen, Maurice, et al. "Cost-effectiveness of Umeclidinium as Add-on to ICS/LABA Therapy in COPD: a UK Perspective." Respiratory Medicine, vol. 145, 2018, pp. 130-137.
Driessen M, Shah D, Risebrough N, et al. Cost-effectiveness of umeclidinium as add-on to ICS/LABA therapy in COPD: A UK perspective. Respir Med. 2018;145:130-137.
Driessen, M., Shah, D., Risebrough, N., Baker, T., Naya, I., Briggs, A., & Ismaila, A. S. (2018). Cost-effectiveness of umeclidinium as add-on to ICS/LABA therapy in COPD: A UK perspective. Respiratory Medicine, 145, pp. 130-137. doi:10.1016/j.rmed.2018.10.024.
Driessen M, et al. Cost-effectiveness of Umeclidinium as Add-on to ICS/LABA Therapy in COPD: a UK Perspective. Respir Med. 2018;145:130-137. PubMed PMID: 30509701.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-effectiveness of umeclidinium as add-on to ICS/LABA therapy in COPD: A UK perspective. AU - Driessen,Maurice, AU - Shah,Dhvani, AU - Risebrough,Nancy, AU - Baker,Timothy, AU - Naya,Ian, AU - Briggs,Andrew, AU - Ismaila,Afisi S, Y1 - 2018/10/24/ PY - 2018/02/15/received PY - 2018/09/17/revised PY - 2018/10/22/accepted PY - 2018/12/5/entrez PY - 2018/12/5/pubmed PY - 2019/10/9/medline KW - Chronic obstructive pulmonary disease KW - Cost-effectiveness KW - Economic evaluation KW - Inhaled corticosteroid KW - Long-acting muscarinic antagonist KW - Long-acting β(2)-agonist SP - 130 EP - 137 JF - Respiratory medicine JO - Respir Med VL - 145 N2 - INTRODUCTION: The cost-effectiveness of long-acting muscarinic antagonist (LAMA) umeclidinium bromide (UMEC) 62.5 μg as add-on therapy to other maintenance COPD treatments is unknown. METHODS: This analysis assessed the cost-effectiveness of the following in COPD: UMEC + fluticasone furoate/vilanterol 100/25 μg (FF/VI); UMEC + fluticasone propionate/salmeterol 250/50 μg (FP/SAL); and UMEC + several alternative choices of inhaled corticosteroid/long-acting β2-agonist (ICS/LABA). The model was informed with direct and indirect data from previously published studies, with a UK perspective and a lifetime horizon. Sensitivity analyses were also performed. RESULTS: For the lifetime horizon, compared with FF/VI, FP/SAL and ICS/LABAs, addition of UMEC was associated with incremental costs per quality-adjusted life-years (QALY) of £4050, £7210 and £5780, respectively, and incremental costs per life year gain of £3380, £6020 and £4940. All UMEC-containing regimens resulted in numerically lower exacerbation rates versus comparator regimens over a lifetime horizon. CONCLUSIONS: Addition of UMEC to various ICS/LABA treatments was associated with higher cost than ICS/LABA alone, but was cost-effective in most scenarios. SN - 1532-3064 UR - https://www.unboundmedicine.com/medline/citation/30509701/Cost-effectiveness_of_umeclidinium_as_add-on_to_ICS/LABA_therapy_in_COPD:_A_UK_perspective L2 - https://linkinghub.elsevier.com/retrieve/pii/S0954-6111(18)30338-X DB - PRIME DP - Unbound Medicine ER -