PRS24 - INFORMING THE PATHWAY OF COPD TREATMENT (IMPACT STUDY) - SINGLE INHALER TRIPLE THERAPY (FF/UMEC/VI) VERSUS FF/VI AND UMEC/VI IN PATIENTS WITH COPD: HEALTHCARE RESOURCE UTILIZATION DATA AND ASSOCIATED COSTS – GERMANY

Abstract

To evaluate differences in healthcare resource utilization (HRU) and associated costs in Germany between the single inhaler triple combination of fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) and dual combinations FF/VI, and UMEC/VI, among patients with symptomatic chronic obstructive pulmonary disease (COPD) with a history of exacerbations using data from the IMPACT trial (NCT02164513). This study is a post-hoc analysis of COPD-related, self-reported HRU data, collected in the 52-week IMPACT study during the on-treatment period, which included unscheduled (i.e., non-study related) visits to a physician office/clinic, urgent care/outpatient center, emergency department, home care, hospital days (general ward and intensive care unit (ICU)), and rescue medication use. Rates of HRU for the intent to treat population were annualised based on per patient rates and the mean number of treatment exposure days. Trial driven visits were excluded from the analysis. Germany-specific unit costs from a payer-perspective were applied to the HRU rates to generate cost estimates (2017, EUR). Over 52 weeks, the mean (SD) number of exposure days per patient were 325.9 (94.9) for FF/UMEC/VI (n=4151), 304.5 (116.2) for FF/VI (n=4134), and 298.7 (120.8) for UMEC/VI (n= 2070), demonstrating higher rates of discontinuation among the dual therapy arms compared to the triple regimen (FF/UMEC/VI). The largest differences in HRU were for mean hospital days, with FF/UMEC/VI (1.26 general ward, 0.16 ICU) and FF/VI (1.28, 0.14) having lower rates than UMEC/VI (1.54, 0.23). Annualised drug costs for FF/UMEC/VI were highest (FF/UMEC/VI=€1,124, FF/VI=€560, UMEC/VI=€708), but costs for other HRU were lowest (€983, €993, €1257), with total costs of €2107, €1553, and €1965. Net incremental total costs for FF/UMEC/VI were €554 versus FF/VI, and €142 versus UMEC/VI. In patients with COPD, treatment with FF/UMEC/VI resulted in similar HRU versus FF/VI and lower HRU costs compared with UMEC/VI.