PRS32 - Cost-Minimization Analysis of Adding a New Single Inhaler Triple Therapy (SITT) for the Treatment of Patients with Chronic Obstructive Pulmonary Disease (Copd) in the UK

Abstract

Single inhaler, once-daily fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) 100/62.5/25μg recently licensed in the EU, was demonstrated non-inferior to its component multiple inhaler triple therapy (MITT) FF/VI + UMEC (Study 200812, 2017) and achieved at least similar health benefits versus alternative MITTs in a network meta-analysis. A cost-minimization analysis (CMA) was developed to compare per patient pharmacy costs of FF/UMEC/VI to licensed MITTs over 1, 5 and 10 years from a UK National Health Service (NHS) perspective. The target population was adults with moderate/ severe COPD, currently treated with triple therapy, as determined by local prescribing data. Not all prescribed MITTs are currently licensed for treatment of COPD in the UK, however, all were included in the weighted price analysis. Only drug acquisition costs were included in this analysis, with cost per day calculated using pack prices from MIMS 2017 together with dose and pack size. The cost of all MITTs was assumed to be the sum of individual ICS/LABA and LAMA component costs. A 3.5% discount rate applied beyond year one. In year one, FF/UMEC/VI was cost-saving compared to all licensed comparators except FF/VI (25μg/100μg) + generic tiotropium (TIO, 16μg), where FF/UMEC/VI was costlier by £20.70 per patient. Cost savings per patient with FF/UMEC/VI ranged from £31 (vs salmeterol/ fluticasone propionate [SAL/FP, 25/125μg] + generic TIO [16μg]) to £376 (vs formoterol fumarate/FP [10/250μg] + TIO [18μg]). When compared to a weighted average cost of prescribed ICS/LABA + LAMA MITTs, FF/UMEC/VI was cost-saving (cost savings of £147 per patient over one year). A similar trend was observed at later timepoints. Inclusion of FF/UMEC/VI on UK NHS formularies would result in at least as good clinical outcomes but with the potential to reduce the drug cost burden of COPD. Funding: GSK (HO1613835)