Introduction To support clinicians and healthcare organisations in their decision making on Chronic Obstructive Pulmonary Disease (COPD) related care, there is a need for studies conducted in patient populations which are representative of everyday clinical practice. The Salford Lung Study (SLS) is an open label prospective randomised controlled effectiveness trial (RCT). The study was conducted between 2012 and 2015. SLS investigated the effectiveness and safety of initiating treatment with once daily fluticasone furoate/vilanterol 100/25 microgram (FF/VI) compared with continuing with usual COPD maintenance treatment (usual care) in patients with COPD in an everyday clinical setting. Compared with usual care, FF/VI statistically significantly reduced the annual rate of moderate and severe exacerbations by 8.41% (NNT = 7) in the intention to treat population (≥1 exacerbation in previous 3 y; n = 2799), and in patients with ≥1 exacerbation in previous 1 y; n = 2269). The current study estimates the potential economic impact of these results in a typical local UK payer environment.
Methods A total of 1000 patients with COPD were included in an Excel based cost-consequence model. The model has a 1-year time-horizon. It was assumed that within one year the use of FF/VI would increase from 5% to 20%. Mean annual rates of moderate/severe exacerbations after twelve months for the ITT population were directly obtained from the RCT and included in the model (1.50 FF/VI and 1.64 usual care). Serious adverse events (SAEs) were excluded from the analysis. Costs were obtained from UK public sources and encompassed annual drug costs (£268 FF/VI; £491 usual care), and COPD exacerbation management costs (moderate £114; severe £2,053).
Results Substituting usual care with FF/VI is likely to be associated with reduced COPD medication and exacerbation management costs. Total annual savings of £34,000 were obtained for a population of 1000 patients with COPD.
Conclusion In an everyday UK clinical setting, substituting usual care with FF/VI in patients with COPD can result in substantial annual cost savings. These results are relevant for clinicians and health care organisations.