Maurice Driessen1, Dhvani Shah2, Nancy Risebrough3, Timothy Baker4, Ian Naya5, Andrew Briggs6, Afisi S Ismaila7. 1. Value Evidence & Outcomes, GSK, Brentford, Middlesex, UK. Electronic address: m.t.driessen@gmail.com. 2. ICON Health Economics, ICON, NY, USA. Electronic address: Dhvani.Shah@iconplc.com. 3. ICON Health Economics, ICON, Toronto, Canada. Electronic address: Nancy.Risebrough@iconplc.com. 4. ICON Health Economics, ICON, NY, USA. Electronic address: Timothy.Baker@iconplc.com. 5. Respiratory Medical Franchise, GSK, Brentford, Middlesex, UK. Electronic address: ian.p.naya@gsk.com. 6. Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK. Electronic address: andrew.briggs@glasgow.ac.uk. 7. 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.
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.
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: Afisi S Ismaila; Nancy Risebrough; Melanie Schroeder; Dhvani Shah; Alan Martin; Emma C Goodall; Kerigo Ndirangu; Gerard Criner; Mark Dransfield; David Mg Halpin; MeiLan K Han; David A Lomas Journal: Int J Chron Obstruct Pulmon Dis Date: 2019-11-29