Journal Article

Cost-Effectiveness of Single-Inhaler Versus Multiple-Inhaler Triple Therapy in COPD: A German Healthcare Perspective

Ismaila, Afisi, Claussen, Jing, Beeh, Kai-Michael, Dasari, Priyadarsini, Noorduyn, Stephen, Kendall, Robyn, Martin, Alan, Shah, Dhvani

2025

Overview

The INTREPID trial showed that once-daily single-inhaler triple therapy (SITT) using fluticasone furoate, umeclidinium, and vilanterol (FF/UMEC/VI) offers clinical benefits versus non-ELLIPTA multiple-inhaler triple therapy (MITT) for the management of chronic obstructive pulmonary disease (COPD) in real-world clinical practice. This analysis evaluated the cost-effectiveness of SITT with FF/UMEC/VI versus non-ELLIPTA MITT for treating symptomatic COPD from a German healthcare perspective. Data from the INTREPID trial, including baseline characteristics, treatment effects (forced expiratory volume in 1 second and St. George's Respiratory Questionnaire score [derived from exploratory COPD assessment test score mapping]), and discontinuation rates, along with German healthcare resource and drug costs (2023 Euros), were used to populate the GALAXY COPD model. The analysis was conducted over a lifetime horizon, with outcomes including life years (LYs), quality-adjusted LYs (QALYs), and incremental cost-utility ratios. The robustness of the analysis was assessed using scenario, one-way sensitivity, and probabilistic analyses. Improved lifetime outcomes were predicted for FF/UMEC/VI versus non-ELLIPTA MITT, providing additional LYs of 0.174 (95% range: 0.065, 0.322) and QALYs of 0.261 (0.186, 0.346) per patient, together with cost savings of €2,850 (€3,517, €2,220). Additionally, patients receiving FF/UMEC/VI were predicted to experience a reduction in exacerbations (-0.063), highlighting its dominance as the preferred treatment option. These findings remained consistent across one-way sensitivity, scenario, and probabilistic analyses, highlighting the robustness of FF/UMEC/VI as a cost-effective solution for COPD management in Germany. FF/UMEC/VI offers clinical benefits and cost savings compared with non-ELLIPTA MITT, suggesting that it may reduce the burden of COPD in Germany and warranting consideration as a preferred treatment option by physicians.

• Publisher: Dove Medical Press Limited,Dove Medical Press Ltd,Dove Press,Dove,Dove Medical Press
• Subject: Administration, Inhalation / Adrenergic beta-2 Receptor Agonists - administration & dosage / Adrenergic beta-2 Receptor Agonists - adverse effects / Adrenergic beta-2 Receptor Agonists - economics / Aerosol therapy / Aged / Androstadienes - administration & dosage / Androstadienes - adverse effects / Androstadienes - economics / Benzyl Alcohols - administration & dosage / Benzyl Alcohols - adverse effects / Benzyl Alcohols - economics / Bronchodilator Agents - administration & dosage / Bronchodilator Agents - adverse effects / Bronchodilator Agents - economics / Chlorobenzenes - administration & dosage / Chlorobenzenes - adverse effects / Chlorobenzenes - economics / Chronic obstructive pulmonary disease / Cost analysis / Cost Savings / Cost-Benefit Analysis / cost-effectiveness / Drug Combinations / Drug Costs / Female / fluticasone furoate/umeclidinium/vilanterol / Forced Expiratory Volume / GDP / Germany / Gross Domestic Product / Humans / Inhalers / Lung - drug effects / Lung - physiopathology / Male / Methods / Middle Aged / Models, Economic / multiple-inhaler triple therapy / Muscarinic Antagonists - administration & dosage / Muscarinic Antagonists - adverse effects / Muscarinic Antagonists - economics / Nebulizers and Vaporizers - economics / Original Research / Patient outcomes / Patients / Pulmonary Disease, Chronic Obstructive - diagnosis / Pulmonary Disease, Chronic Obstructive - drug therapy / Pulmonary Disease, Chronic Obstructive - economics / Pulmonary Disease, Chronic Obstructive - physiopathology / Quality of life / Quality-Adjusted Life Years / Quinuclidines - administration & dosage / Quinuclidines - adverse effects / Quinuclidines - economics / Recovery of Function / single-inhaler triple therapy / Social isolation / Time Factors / Treatment Outcome