Indacaterol/glycopyrronium (IND/GLY) is cost-effective compared with salmeterol/fluticasone (SFC) in Swedish chronic obstructive pulmonary disease (COPD) patients

Introduction/Aim: Results from the recent one-year FLAME study demonstrated superior efficacy of IND/GLY over SFC in reducing the annual rate of moderate and severe exacerbations in COPD patients with moderate to very severe airflow limitation and ≥1 exacerbation in the preceding year. This economic evaluation aims to determine whether this clinical effect translates into health economic benefits using a cost-effectiveness analysis from the Swedish payer’s perspective. Methods: A previously published and validated patient-level simulation model was updated with population and clinical data from the FLAME study and exacerbation and maintenance cost data from the real-world retrospective ARCTIC Swedish cohort study (n=18,586). Both direct costs and benefits were analyzed over various time horizons and were discounted at 3% per annum. Here, we present results for the time horizon of 3 years. Results: IND/GLY was associated with lower total direct costs and better outcomes compared with SFC over the time horizon of 3 years. Results showed that the use of IND/GLY over SFC resulted in an incremental gain in 0.008 quality-adjusted life-years and 0.005 life-years with cost savings of €732 per patient. The average number of moderate and severe exacerbations per patient was predicted lower with the use of IND/GLY compared with SFC at 3 years (1.98 vs. 2.39). Conclusion: This cost-effectiveness analysis showed that treatment with IND/GLY is more effective and less costly compared to treatment with SFC in Swedish COPD patients with moderate to very severe airflow limitation and ≥1 exacerbation in the preceding year.