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Cost-Effectiveness Of Once-Daily Single-Inhaler Triple Therapy In COPD: The IMPACT Trial.
Int J Chron Obstruct Pulmon Dis. 2019; 14:2681-2695.IJ

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.

Authors+Show Affiliations

Value Evidence and Outcomes, GlaxoSmithKline plc, Collegeville, PA, USA. Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.ICON Health Economics, ICON plc, Toronto, ON, Canada.Value Evidence and Outcomes, GlaxoSmithKline plc, Brentford, UK.ICON Health Economics, ICON plc, New York, NY, USA.Value Evidence and Outcomes, GlaxoSmithKline plc, Uxbridge, UK.Health Economics and Outcomes Research, GlaxoSmithKline plc, Mississauga, ON, Canada.ICON Health Economics, ICON plc, New York, NY, USA.Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.Division of Pulmonary, Allergy, and Critical Care Medicine, Lung Health Center, University of Alabama at Birmingham, Birmingham, AL, USA.Department of Respiratory Medicine, Royal Devon and Exeter Hospital, Exeter, UK.University of Michigan, Pulmonary and Critical Care, Ann Arbor, MI, USA.UCL Respiratory, University College London, London, UK.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

31819401

Citation

Ismaila, Afisi S., et al. "Cost-Effectiveness of Once-Daily Single-Inhaler Triple Therapy in COPD: the IMPACT Trial." International Journal of Chronic Obstructive Pulmonary Disease, vol. 14, 2019, pp. 2681-2695.
Ismaila AS, Risebrough N, Schroeder M, et al. Cost-Effectiveness Of Once-Daily Single-Inhaler Triple Therapy In COPD: The IMPACT Trial. Int J Chron Obstruct Pulmon Dis. 2019;14:2681-2695.
Ismaila, A. S., Risebrough, N., Schroeder, M., Shah, D., Martin, A., Goodall, E. C., Ndirangu, K., Criner, G., Dransfield, M., Halpin, D. M., Han, M. K., & Lomas, D. A. (2019). Cost-Effectiveness Of Once-Daily Single-Inhaler Triple Therapy In COPD: The IMPACT Trial. International Journal of Chronic Obstructive Pulmonary Disease, 14, 2681-2695. https://doi.org/10.2147/COPD.S216072
Ismaila AS, et al. Cost-Effectiveness of Once-Daily Single-Inhaler Triple Therapy in COPD: the IMPACT Trial. Int J Chron Obstruct Pulmon Dis. 2019;14:2681-2695. PubMed PMID: 31819401.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-Effectiveness Of Once-Daily Single-Inhaler Triple Therapy In COPD: The IMPACT Trial. AU - Ismaila,Afisi S, AU - Risebrough,Nancy, AU - Schroeder,Melanie, AU - Shah,Dhvani, AU - Martin,Alan, AU - Goodall,Emma C, AU - Ndirangu,Kerigo, AU - Criner,Gerard, AU - Dransfield,Mark, AU - Halpin,David Mg, AU - Han,MeiLan K, AU - Lomas,David A, Y1 - 2019/11/29/ PY - 2019/05/17/received PY - 2019/11/01/accepted PY - 2019/12/11/entrez PY - 2019/12/11/pubmed PY - 2020/4/28/medline KW - Canada KW - chronic obstructive pulmonary disease KW - cost-effectiveness KW - quality-adjusted life years KW - single-inhaler triple therapy SP - 2681 EP - 2695 JF - International journal of chronic obstructive pulmonary disease JO - Int J Chron Obstruct Pulmon Dis VL - 14 N2 - 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. SN - 1178-2005 UR - https://www.unboundmedicine.com/medline/citation/31819401/Cost_Effectiveness_Of_Once_Daily_Single_Inhaler_Triple_Therapy_In_COPD:_The_IMPACT_Trial_ L2 - https://dx.doi.org/10.2147/COPD.S216072 DB - PRIME DP - Unbound Medicine ER -