Budget Impact Analysis of Single-Inhaler Fluticasone Furoate/Umeclidinium/Vilanterol in Patients with Asthma in the Dubai Academic Healthcare Corporation

Abstract

Purpose

Asthma is a common, chronic respiratory disorder associated with substantial societal and economic burden globally, despite the availability of different treatment modalities. GSK has developed a once-daily single-inhaler triple therapy (SITT), comprised of fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI); a combination of inhaled corticosteroid, long-acting muscarinic antagonist, and long-acting β₂-agonist for patients with uncontrolled asthma. A budget impact analysis was conducted to determine the financial impact of introducing FF/UMEC/VI SITT from the perspective of the Dubai Academic Healthcare Corporation (DAHC).

Methods

A budget impact model was constructed using an epidemiology-based approach and used to estimate the expected 5-year budget impact of including FF/UMEC/VI for the treatment of eligible patients within the DAHC in the United Arab Emirates (UAE). The model included both pharmacy and efficacy-related costs. The perspective of the DAHC healthcare payer was adopted, thus only direct payer costs were included in the analysis. A one-way sensitivity analysis was conducted to test the robustness of the model structure, assumptions, and input parameters.

Results

The total budget impact was estimated to save 1 million United States Dollars (USD) over 5 years, with budget impacts of 0.08 million USD in Year 1; 0.14 million USD in Year 2; 0.22 million USD in Year 3; 0.28 million USD in Year 4; and 0.33 million USD in Year 5. The overall budget impact per patient was estimated to save 12.2 USD over 5 years. In one-way sensitivity analyses, the budget impact was most sensitive to changes in the market uptake of FF/UMEC/VI.

Conclusion

Healthcare payers may consider FF/UMEC/VI in the management of uncontrolled asthma which would save costs and reduce healthcare resource use in the UAE.

Keywords:

• asthma
• asthma maintenance therapy
• budget impact analysis
• triple therapy
• United Arab Emirates

Abbreviations

ACQ-7, 7-item Asthma Control Questionnaire; DAHC, Dubai Academic Healthcare Corporation; FF, fluticasone furoate; GINA, Global Initiative for Asthma; HCRU, healthcare resource use; ICS, inhaled corticosteroid; LABA, long-acting β₂-agonist; LAMA, long-acting muscarinic antagonist; MITT, multiple-inhaler triple therapy; OCS, oral corticosteroid; SITT, single-inhaler triple therapy; UAE, United Arab Emirates; UMEC, umeclidinium; USD, United States Dollars; VI, vilanterol.

Data Sharing Statement

Model input parameters were derived from public sources and peer-reviewed research, which have been cited in the manuscript where applicable and included in the Supplementary Material. The budget impact model adaptation is available upon written request to the corresponding author.

Ethics Approval

While the approach taken to obtain anonymized and aggregated data inputs for this budget impact analysis adaptation does not fall within GSK’s definition of Human Subject Research, confirmation was still obtained from the relevant Ethics Committee of the Dubai Academic Healthcare Corporation that prior ethics approval was not required for the budget impact analysis adaptation, except a notification prior to external publication of the analysis.

Acknowledgments

Editorial support (in the form of writing assistance, including collating and incorporating authors’ comments for each draft, assembling tables and figures, grammatical editing and referencing) was provided by Lisa Carne, PhD, and Ben Usher, PhD, of Fishawack Indicia Ltd, UK, part of Fishawack Health, and was funded by GSK.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

MH is an employee of GSK; SAD is President of the Emirates Health Economics Society; MF has no competing interests. The authors report no other conflicts of interest in this work.

Additional information

Funding

This study was funded by GSK (GSK study number: 217669). The funding agreement ensured the authors’ independence in designing the study, interpreting the data, writing, and publishing the report. The following authors are employed by the sponsor: Mohamed Hamouda.