TY - JOUR
T1 - Cost-Effectiveness of Single-versus Multiple-Inhaler Triple Therapy in a UK COPD Population
T2 - The INTREPID Trial
AU - Halpin, David M.G.
AU - Kendall, Robyn
AU - Shukla, Soham
AU - Martin, Alan
AU - Shah, Dhvani
AU - Midwinter, Dawn
AU - Beeh, Kai M.
AU - Kocks, Janwillem W.H.
AU - Jones, Paul W.
AU - Compton, Chris
AU - Risebrough, Nancy A.
AU - Ismaila, Afisi S.
N1 - Funding Information:
This analysis was funded by GSK (study number 212888). The INTREPID trial was also funded by GSK (NCT03467425). The sponsor was involved in study conception and design, and the decision to submit the article for publication. The sponsor was also given the opportunity to review the manuscript for medical and scientific accuracy as well as intellectual property considerations.
Funding Information:
CC, PWJ, ASI, DM, AM, and SS are employees of GSK and/or hold stocks/shares in GSK. ASI is also an unpaid faculty member at McMaster University, Hamilton, ON, Canada. Current affiliation details for CC and PWJ: General Medicines Therapy Area, GSK, Brentford, UK. Current affiliation details for AM: Value Evidence and Outcomes, GSK, Brentford, UK. RK, DS, and NAR are employees of ICON; ICON received funding from GSK to conduct the analysis.
Funding Information:
Editorial support (in the form of writing assistance, including preparation of the draft manuscript under the direction and guidance of the authors, collating and incorporating authors’ comments for each draft, assembling tables and figures, grammatical editing, and referencing) was provided by Rebecca Cunningham, of Aura, a division of Spirit Medical Communications Group Limited, and was funded by GSK.
Publisher Copyright:
© 2022 Halpin et al.
PY - 2022/10/25
Y1 - 2022/10/25
N2 - Purpose: The 24-week INTREPID trial demonstrated the clinical benefits of once-daily single-inhaler triple therapy (SITT) with fluticasone furoate, umeclidinium, and vilanterol (FF/UMEC/VI) versus non-ELLIPTA multiple-inhaler triple therapy (MITT) in patients with symptomatic chronic obstructive pulmonary disease (COPD). This analysis assessed the cost-effectiveness of FF/UMEC/VI versus non-ELLIPTA MITT for the treatment of symptomatic COPD from a United Kingdom (UK) National Health Service (NHS) perspective.Patients and Methods: The analysis was conducted using the validated GALAXY COPD disease progression model. Baseline characteristics, treatment effect parameters (forced expiratory volume in 1 second and St. George’s Respiratory Questionnaire score [derived from exploratory COPD Assessment Test score mapping]), and discontinuation data from INTREPID were used to populate the model. UK healthcare resource and drug costs (2020 British pounds) were applied, and costs and outcomes were discounted at 3.5%. Analyses were conducted over a lifetime horizon from a UK NHS perspective. Model outputs included exacerbation rates, total costs, life years (LYs), quality-adjusted LYs (QALYs) and incremental cost-effectiveness ratio per QALY. Sensitivity analyses were conducted to assess the robustness of the results by varying parameter values and assumptions.Results: Over a lifetime horizon, FF/UMEC/VI provided an additional 0.174 (95% confidence interval [CI]: 0.024, 0.344) LYs (approximately 2 months), and 0.253 (95% CI: 0.167, 0.346) QALYs (approximately 3 months), at a cost saving of £1764 (95% CI: −£2600, −£678) per patient, compared with non-ELLIPTA MITT. FF/UMEC/VI remained the dominant treatment option, meaning greater benefits at lower costs, across all scenario and sensitivity analyses.Conclusion: Based on this analysis, in a UK setting, FF/UMEC/VI would improve health outcomes and reduce costs compared with non-ELLIPTA MITT for the treatment of patients with symptomatic COPD. SITT may help to reduce the clinical and economic burden of COPD and should be considered by physicians as a preferred treatment option.
AB - Purpose: The 24-week INTREPID trial demonstrated the clinical benefits of once-daily single-inhaler triple therapy (SITT) with fluticasone furoate, umeclidinium, and vilanterol (FF/UMEC/VI) versus non-ELLIPTA multiple-inhaler triple therapy (MITT) in patients with symptomatic chronic obstructive pulmonary disease (COPD). This analysis assessed the cost-effectiveness of FF/UMEC/VI versus non-ELLIPTA MITT for the treatment of symptomatic COPD from a United Kingdom (UK) National Health Service (NHS) perspective.Patients and Methods: The analysis was conducted using the validated GALAXY COPD disease progression model. Baseline characteristics, treatment effect parameters (forced expiratory volume in 1 second and St. George’s Respiratory Questionnaire score [derived from exploratory COPD Assessment Test score mapping]), and discontinuation data from INTREPID were used to populate the model. UK healthcare resource and drug costs (2020 British pounds) were applied, and costs and outcomes were discounted at 3.5%. Analyses were conducted over a lifetime horizon from a UK NHS perspective. Model outputs included exacerbation rates, total costs, life years (LYs), quality-adjusted LYs (QALYs) and incremental cost-effectiveness ratio per QALY. Sensitivity analyses were conducted to assess the robustness of the results by varying parameter values and assumptions.Results: Over a lifetime horizon, FF/UMEC/VI provided an additional 0.174 (95% confidence interval [CI]: 0.024, 0.344) LYs (approximately 2 months), and 0.253 (95% CI: 0.167, 0.346) QALYs (approximately 3 months), at a cost saving of £1764 (95% CI: −£2600, −£678) per patient, compared with non-ELLIPTA MITT. FF/UMEC/VI remained the dominant treatment option, meaning greater benefits at lower costs, across all scenario and sensitivity analyses.Conclusion: Based on this analysis, in a UK setting, FF/UMEC/VI would improve health outcomes and reduce costs compared with non-ELLIPTA MITT for the treatment of patients with symptomatic COPD. SITT may help to reduce the clinical and economic burden of COPD and should be considered by physicians as a preferred treatment option.
KW - chronic obstructive pulmonary disease
KW - cost-effectiveness
KW - health technology assessment
KW - pragmatic
KW - real-world
KW - triple therapy
U2 - 10.2147/COPD.S370577
DO - 10.2147/COPD.S370577
M3 - Article
AN - SCOPUS:85140476282
VL - 17
SP - 2745
EP - 2755
JO - International Journal of Chronic Obstructive Pulmonary Disease
JF - International Journal of Chronic Obstructive Pulmonary Disease
SN - 1176-9106
ER -