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The long-term clinical and economic benefits of treating advanced COPD patients with single-inhaler triple therapy in Quebec, Canada - The IMPACT trial.
Risebrough, Nancy A; Mursleen, Sara; Ndirangu, Kerigo; Shah, Dhvani; Martin, Alan; Schroeder, Melanie; Ismaila, Afisi S.
Afiliación
  • Risebrough NA; ICON Global Health Economics and Outcomes Research, ICON plc, Toronto, ON, M2N 1A2, Canada. Electronic address: nancy.risebrough@iconplc.com.
  • Mursleen S; Health Economics and Outcomes Research, GSK, Mississauga, ON, L5R 3G2, Canada. Electronic address: sara.x.mursleen@gsk.com.
  • Ndirangu K; ICON Global Health Economics and Outcomes Research, ICON plc, New York, NY, 11735, USA. Electronic address: kgndirangu@gmail.com.
  • Shah D; ICON Global Health Economics and Outcomes Research, ICON plc, New Jersey, NJ 07302, USA. Electronic address: dhvani.shah@iconplc.com.
  • Martin A; Value Evidence and Outcomes, GSK, Brentford, TW8 9GS, UK. Electronic address: alan.a.martin@gsk.com.
  • Schroeder M; Value Evidence and Outcomes, GSK, Brentford, TW8 9GS, UK. Electronic address: melanie.x.schroeder@viivhealthcare.com.
  • Ismaila AS; Value Evidence and Outcomes, GSK, Collegeville, PA, 19426-0989, USA; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, L8S 4K1, Canada. Electronic address: afisi.s.ismaila@gsk.com.
Respir Med ; 231: 107694, 2024 Sep.
Article en En | MEDLINE | ID: mdl-38844004
ABSTRACT

BACKGROUND:

This cost-utility analysis assessed the long-term clinical and economic benefits of fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) triple therapy vs FF/VI or UMEC/VI from a Quebec societal perspective in patients with chronic obstructive pulmonary disease (COPD) with ≥1 moderate/severe exacerbation in the previous year.

METHODS:

The validated GALAXY disease progression model was utilized, with parameters set to baseline and efficacy data from IMPACT. Treatment costs (2017 Canadian dollars [C$]) were estimated using Quebec-specific unit costs. Costs and health outcomes were discounted at 1.5 %/year. A willingness-to-pay threshold of C$50,000/quality-adjusted life year (QALY) was considered cost-effective. Outcomes modeled were exacerbation rates, QALYs, life years (LYs), costs and incremental cost-effectiveness ratios (ICERs). Subgroup analyses were performed according to prior treatment, exacerbation history in the previous year, and baseline lung function.

RESULTS:

Over a lifetime horizon, FF/UMEC/VI resulted in more QALYs and LYs gained, at a small incremental cost compared with FF/VI and UMEC/VI. From a societal perspective, the estimated ICER for the base case was C$18,152/QALY vs FF/VI, and C$15,847/QALY vs UMEC/VI. For the subgroup analyses (FF/UMEC/VI compared with FF/VI and UMEC/VI), ICERs ranged from C$17,412-25,664/QALY and C$16,493-18,663/QALY (prior treatment); C$15,247-19,924/QALY and C$15,444-28,859/QALY (exacerbation history); C$14,025-34,154/QALY and C$16,083-17,509/QALY (baseline lung function).

INTERPRETATION:

FF/UMEC/VI was predicted to improve outcomes and be cost-effective vs both comparators in the base case and all subgroup analyses, and based on this analysis would be an appropriate investment of health service funds in Quebec. CLINICAL TRIAL REGISTRATION NUMBER IMPACT trial NCT02164513.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Quinuclidinas / Alcoholes Bencílicos / Clorobencenos / Análisis Costo-Beneficio / Años de Vida Ajustados por Calidad de Vida / Enfermedad Pulmonar Obstructiva Crónica / Androstadienos País/Región como asunto: America do norte Idioma: En Revista: Respir Med Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Quinuclidinas / Alcoholes Bencílicos / Clorobencenos / Análisis Costo-Beneficio / Años de Vida Ajustados por Calidad de Vida / Enfermedad Pulmonar Obstructiva Crónica / Androstadienos País/Región como asunto: America do norte Idioma: En Revista: Respir Med Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido