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 -