Single versus multiple inhaler triple therapy in COPD using data from the pragmatic INTREPID trial: cost-effectiveness analysis from the Chilean public healthcare system perspective

BACKGROUND: Chronic obstructive pulmonary disease (COPD) imposes a substantial economic burden in Chile. This study assessed the cost-effectiveness of fluticasone furoate, umeclidinium, and vilanterol (FF/UMEC/VI) once daily via single inhaler compared to multiple inhaler triple therapy (MITT) for moderate to severe COPD, from the Chilean public healthcare system perspective. RESEARCH DESIGN AND METHODS: The Galaxy COPD disease progression model was adapted to the Chilean setting, incorporating Chilean healthcare resource use and unit costs, along with patient data, comparators, and treatment effects from INTREPID trial. Costs and healthcare benefits were aggregated over 25 years and reported as incremental cost-effectiveness ratios (ICERs - cost/quality-adjusted life year [QALY] gained). Sensitivity analysis included probabilistic assessment. RESULTS: Single inhaler FF/UMEC/VI provided an additional 0.261 QALYs at an incremental cost of 114.21 United States Dollars (USD) per patient, leading to an ICER of 438.41 USD/QALY in the base case. FF/UMEC/VI reduced severe exacerbations per patient per year by 4.38% compared to MITT. FF/UMEC/VI was dominant over MITT in 5- and 10-year time horizons. CONCLUSIONS: Despite higher total costs due to increased drug acquisition, FF/UMEC/VI reduces healthcare resource utilization associated with COPD events, representing a cost-effective option compared to MITT for moderate to severe COPD in Chile.