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j.chest.2017.08.214

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Chest Infections
SESSION TITLE: Respiratory Care
SESSION TYPE: Original Investigation Slide
PRESENTED ON: Tuesday, October 31, 2017 at 08:45 AM - 10:00 AM
Within-Trial Cost Analysis of COPD Exacerbations From the Summit Clinical Outcomes Study of
Fluticasone Furoate/Vilanterol Inhalation
Richard Stanford* Anna Coutinho Michael Eaddy Binglin Yue and Michael Bogart GlaxoSmithKline, Research Triangle
Park, NC
PURPOSE: To assess the economic benefits of treating COPD patients with cardiovascular (CV) risk using data from a large
clinical outcomes study.
METHODS: A retrospective economic analysis from the U.S. healthcare system payer perspective was conducted using withintrial data of the intent-to-treat population from the Study to Understand Mortality and Morbidity in COPD (SUMMIT). The
objective of the economic analysis was to compare 1-year costs of on-treatment moderate/severe COPD exacerbations between
each active treatment comparator, fluticasone furoate 100 mcg/vilanterol 25 mcg (FF/VI), fluticasone furoate 100 mcg (FF), and
vilanterol 25 mcg (FF) versus placebo (PBO). Analysis: The total cost of COPD exacerbations were obtained by applying the unit
cost estimates obtained from a large US managed care database to the number of events occurring during each patient’s follow-up.
These unit costs were determined in a cohort of COPD patients with CV risk. Mean costs for COPD exacerbations were then
computed for all the 4 treatment cohorts using inverse probability treatment weighting (IPTW) to account for censoring. The
average duration of follow-up was 1.7 years; however the pre-defined follow-up period of observation for estimation of costs was
set at 1 year. Bootstrapping was performed to estimate 95% CI around the mean. The incremental mean cost difference from PBO
was also estimated using the same boot strapping methods.
CONCLUSIONS: The estimated cost of moderate/severe exacerbations in subjects with COPD and CV risk were lower for all
treatments compared to no treatment within the SUMMIT trial. The cost reduction was greatest with FF/VI treatment. (GSK
Study HO-15-15547).
CLINICAL IMPLICATIONS: Clinicians and payers may be able decrease the cost of COPD care by effectively treating COPD in
COPD patients with CV risk.
DISCLOSURE: Richard Stanford: Employee: GSK, Shareholder: GSK Anna Coutinho: Employee: Xcenda, which received
consulting fees to conduct the research Michael Eaddy: Employee: Xcenda, which received consulting fees to conduct the research
Binglin Yue: Employee: Xcenda, which received consulting fees to conduct the research Michael Bogart: Employee: GSK,
Shareholder: GSK
No Product/Research Disclosure Information
DOI:
http://dx.doi.org/10.1016/j.chest.2017.08.214
Copyright ª 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
chestjournal.org
183A
CHEST INFECTIONS
RESULTS: A total of 16 485 subjects were evaluated (4111 PBO, 4121 FF/VI, 4118 VI and 4135 FF) were assessed, average age of
65 years of age and about 75% male. Mean 1-year cost of moderate/severe exacerbations were significantly lower (p<0.001) for
FF/VI ($2468, 95% CI, $2158, $2792), FF ($2592, 95% CI, $2302, $2900) and VI ($2708, 95% CI, $2392, $3073) compared to PBO
($3386, 95% CI, $3015, $3792). Mean difference in 1-year cost from PBO for moderate/severe exacerbations were FF/VI: $981
(95% CI, $934, $902), FF: $794 (95% CI, $810, $779), and VI: $678 (95% CI, $694, $662).
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