Introduction The Salford Lung Study (SLS) is an open label prospective randomised controlled effectiveness trial. The study was conducted in the UK between 2012 and 2015 in a population intended to be representative of everyday clinical practice and was intended to provide relevant evidence to support healthcare decisions in the management of Chronic Obstructive Pulmonary Disease (COPD) for clinicians, providers and policy makers. SLS investigated the effectiveness and safety of initiating treatment with fluticasone furoate/vilanterol (FF/VI) 100/25 mcg compared with continuing with usual COPD maintenance treatment (usual care). 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 (ITT) population (>1 exacerbation in the previous 3 y; n = 2799) and in patients with >1 exacerbation in the previous 1 y; n = 2269). The objective of the present analysis is to estimate the economic impact of these results when applied to a Spanish setting.
Methods An Excel based 1-year cost-consequence model was developed based on SLS results and from the Spanish National Health System (NHS) perspective. Mean annual rates of moderate/severe exacerbations were directly obtained from SLS (1.50 FF/VI and 1.64 usual care; ITT population). Serious adverse events were excluded from the analysis. Patients included in the analysis were diagnosed COPD patients >40 years old, being treated with a maintenance treatment and having a history of exacerbations (N = 232,730, estimated from Spanish prevalence data). Costs were estimated from Spanish public sources and encompassed annual retail drug costs (FF/VI: 627.26 €, usual care: 782.24 €) and COPD exacerbation management costs (344€: moderate event; 903 €: severe event).It was assumed that within one year the use of FF/VI would increase from 3% to 10%.
Results Substituting usual care with FF/VI is likely to be associated with reduced COPD medication and exacerbation management costs. Total annual savings of 3,236,647 € were obtained for this population.
Conclusion The decreased rate of exacerbations with FF/VI compared with usual care observed in SLS trial could be transferable, translating into potential healthcare savings for the Spanish NHS. SLS results may support informed healthcare decisions across different settings.