Cost effectiveness of umeclidinium bromide 62.5μg plus ICS/LABA versus ICS/LABA in COPD

Introduction: Information about the cost effectiveness of add-on treatments for chronic obstructive pulmonary disease (COPD) is needed. Objectives To evaluate the cost effectiveness of once-daily umeclidinium bromide 62.5μg (UMEC) added to inhaled corticosteroids/long-acting β2-agonists (ICS/LABA) versus ICS/LABA in the United Kingdom (UK). Methods: A linked-equation model estimated disease progression, associated health service costs, and impact on quality-adjusted life-years and survival. Statistical risk equations for clinical endpoints and resource use were derived from the ECLIPSE and TORCH studies, respectively. Model baseline inputs and treatment effects were obtained from GSK trials (Siler et al. COPD 2016;13:1–10; Siler et al. Respir Med 2015;109:1155–63) and discontinuation rates from the UPLIFT study. A lifetime horizon was used and costs and effects were discounted at 3.5%. Analyses were performed from the UK National Health Service perspective. Results: Against slightly higher costs, UMEC added to ICS/LABA resulted in improved outcomes. Incremental cost-effectiveness ratios remained within recognised cost-effectiveness thresholds. Sensitivity analyses showed that variation in main parameters did not alter the results including at shorter time horizons of 5 and 10 years. Conclusions Against slightly higher costs, UMEC improves health outcomes when added to ICS/LABA in COPD in the UK. Funding GSK (HO-15-8059)