Cost-effectiveness of umeclidinium compared with tiotropium and glycopyrronium as monotherapy for chronic obstructive pulmonary disease: a UK perspective

Table 1 Model inputs: baseline demographics (ITT populations), drug costs and resource costs

Parameters	Analysis 1 (UMEC vs TIO)	Analysis 2 (UMEC vs GLY)
Female, %	28.0	32.0
Age (years), mean (SE)	64.2 (0.3)	64.1 (0.3)
BMI, %
Low	10.0	10.0
Medium	65.0	61.0
High	25.0	29.0
Any CVD comorbidity, %	64.0	68.0
Any other comorbidity, %	87.0	89.0
No prior exacerbations at baseline, %	69.0	69.0
mMRC score ≥ 2, %	100.0	100.0
Current smokers, %	51.0	47.0
Height (cm), mean (SE)	169.3 (0.3)	168.8 (0.3)
Number of exacerbations in previous year, mean (SE)	0.42 (0.02)	0.40 (0.02)
Number of severe exacerbations, mean	0.13	0.11
Baseline SGRQ score (units), mean (SE)	45.2 (0.6)	44.7 (0.5)
Derived baseline utility, mean	0.730	0.733
Baseline FEV₁ % predicted, mean (SE)	50.7 (0.3)	50.5 (0.3)
Fibrinogen (mcg/dL), mean (SE)^a	459.5 (2.37)	461.5 (2.37)
6MWT distance (m)^a	362.9	361.05
Relative treatment effects (UMEC vs comparator)^b
FEV₁ increment (mL), mean (SE)	53.0 (14.3)	33.0 (14.3)
SGRQ change (units), mean (SE)	− 0.5 (0.8)	− 0.6 (0.8)
Daily drug costs (£)
UMEC	0.92	0.92
Reference drug	TIO: 1.16	GLY: 0.92
Hospital costs (£)^c
ICU (cost/day)	1260	1260
General ward (cost/day)	402	402
COPD-related hospitalisation (cost per episode)	1420	1420
ER visit (cost per visit)	187	187
Outpatient visit (initial visit)	199	199
Outpatient visit (subsequent visit)	147	147
Physician visit costs (£)^d
Day time home visit	128	128
Night time home visit	128 (assumption)	128 (assumption)
Visit to physician’s office	65	65
Telephone consultation	27	27

Baseline demographics for each treatment arm were pooled in each analysis. Cost data are presented to three significant figures
6MWT 6-min walk test, BMI body mass index, COPD chronic obstructive pulmonary disease, CVD cardiovascular disease, ER emergency room, FEV₁ forced expiratory volume in 1 s, GLY glycopyrronium, ICU intensive care unit, ITT intent-to-treat, Mmrc modified Medical Research Council, NHS National Health Service, SE standard error, SGRQ St George’s Respiratory Questionnaire, TIO tiotropium, UMEC umeclidinium
^a Baseline fibrinogen and 6MWT distance were not available in the trial data but were predicted based on risk equations
^b To avoid double-counting of treatment effects an iterative approach was used to adjust the magnitude of the SGRQ treatment effect entered into the model. This ensured that the predicted clinical outcomes matched the observed trial data
^c Department of Health, NHS Reference costs 2014–2015 [33]
^d Personal Social Services Research Unit. Unit costs of health & social care [32]

ISSN: 1478-7547