Abstract
Introduction United Kingdom management costs for chronic obstructive pulmonary disease, estimated at £1.9 billion·year−1, are rising. In the FULFIL (Lung Function and Quality of Life Assessment in Chronic Obstructive Pulmonary Disease with Closed Triple Therapy) study, single-inhaler triple therapy with fluticasone furoate/umeclidinium/vilanterol (100/62.5/25 µg) improved clinical outcomes versus budesonide/formoterol (400/12 µg) in patients with symptomatic chronic obstructive pulmonary disease at risk of exacerbations. We assessed the cost-effectiveness of fluticasone furoate/umeclidinium/vilanterol versus budesonide/formoterol for treating chronic obstructive pulmonary disease from a United Kingdom National Health Service perspective.
Methods A model was developed combining a trial-based and Markov component and populated with baseline and treatment effect data from FULFIL, together with United Kingdom healthcare resource costs and disease-related utilities. Costs per life year and per quality-adjusted life year gained (costing year 2017) for fluticasone furoate/umeclidinium/vilanterol versus budesonide/formoterol were calculated for a lifetime horizon. Results were explored using deterministic sensitivity, scenario and probabilistic analyses.
Results Fluticasone furoate/umeclidinium/vilanterol was associated with gains in life years (0.533) and quality-adjusted life years (0.506) versus budesonide/formoterol, but at slightly increased total costs (£26 416 versus £25 860). This translated to incremental cost-effectiveness ratios of £1042/life year and £1098/quality-adjusted life year for fluticasone furoate/umeclidinium/vilanterol versus budesonide/formoterol. In scenario analyses, incremental cost-effectiveness ratios ranged from dominant to £1547/quality-adjusted life year gained.
Conclusions Fluticasone furoate/umeclidinium/vilanterol provides a cost-effective treatment option versus budesonide/formoterol for patients with symptomatic chronic obstructive pulmonary disease in the United Kingdom.
Footnotes
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Conflict of interest: E. Fenwick reports GSK provided funds to ICON plc to build the model and conduct the analysis in the present study.
Conflict of interest: Dr. Martin reports and He is an employee of GlaxoSmithKline.
Conflict of interest: Melanie Schroeder
Conflict of interest: Mr. Mealing reports grants from GlaxoSmithKline plc, during the conduct of the study and grants from GlaxoSmithKline plc, outside the submitted work, all of which was paid to ICON Health Economics.
Conflict of interest: OYINKANSOLA SOLANKE reports personal fees from GlaxoSmithKline plc, during the conduct of the study.
Conflict of interest: Dr. Risebrough has nothing to disclose.
Conflict of interest: A.S. Ismaila reports the study was funded GlaxoSmithKline, of which A.S. Ismaila is an employee and shareholder. A.S. Ismaila is also an unpaid, part-time professor at McMaster University.
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- Received July 8, 2020.
- Accepted November 17, 2020.
- Copyright ©ERS 2020
This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.
