Cost-effectiveness of umeclidinium as add-on to ICS/LABA therapy in COPD: A UK perspective. (December 2018)

• Record Type: Journal Article
• Authors: Driessen, Maurice; Shah, Dhvani; Risebrough, Nancy; Baker, Timothy; Naya, Ian; Briggs, Andrew; Ismaila, Afisi S.
• Is Part Of: Respiratory medicine. Volume 145(2018)
• Page Start: 130
• Page End: 137
• Publication Date: 2018-12
• Subjects: Chronic obstructive pulmonary disease -- Cost-effectiveness -- Long-acting muscarinic antagonist -- Inhaled corticosteroid -- Long-acting β2-agonist -- Economic evaluation; Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2018.10.024
• Languages: English
• ISSNs: 0954-6111

Abstract

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. Highlights: UMEC + ICS/LABA was associated with greater QALY gains than ICS/LABA alone. UMEC + ICS/LABA was slightly more costly than ICS/LABA alone. UMEC + ICS/LABA resulted in numerically lower exacerbation rates than ICS/LABA. UMEC + ICS/LABA was cost-effective in most scenarios versus ICS/LABA alone.