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International Journal of Chronic Obstructive Pulmonary Disease Volume 18, 2023 - Issue
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ORIGINAL RESEARCH

Comparative Effectiveness of Umeclidinium/Vilanterol versus Inhaled Corticosteroid/Long-Acting β2-Agonist in Patients with Chronic Obstructive Pulmonary Disease in a Primary Care Setting in England

Alexandrosz Czira1 R&D Global Medical, GSK, Brentford, Middlesex, UKCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0002-3395-6186View further author information
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Gema Requena1 R&D Global Medical, GSK, Brentford, Middlesex, UKORCID Iconhttps://orcid.org/0000-0002-1889-6656View further author information
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Victoria Banks2 Real-World Evidence, Adelphi Real World, Bollington, Cheshire, UKORCID Iconhttps://orcid.org/0000-0002-0087-7641View further author information
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Robert Wood2 Real-World Evidence, Adelphi Real World, Bollington, Cheshire, UKORCID Iconhttps://orcid.org/0000-0002-6977-435XView further author information
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Theo Tritton2 Real-World Evidence, Adelphi Real World, Bollington, Cheshire, UKView further author information
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Catherine M Castillo2 Real-World Evidence, Adelphi Real World, Bollington, Cheshire, UKORCID Iconhttps://orcid.org/0000-0002-7204-6169View further author information
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Jie Yeap2 Real-World Evidence, Adelphi Real World, Bollington, Cheshire, UKView further author information
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Rosie Wild2 Real-World Evidence, Adelphi Real World, Bollington, Cheshire, UKORCID Iconhttps://orcid.org/0000-0002-9963-6441View further author information
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Chris Compton1 R&D Global Medical, GSK, Brentford, Middlesex, UKORCID Iconhttps://orcid.org/0000-0002-7564-5343View further author information
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Kieran J Rothnie1 R&D Global Medical, GSK, Brentford, Middlesex, UKORCID Iconhttps://orcid.org/0000-0003-4279-1624View further author information
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Felix Herth3 Department of Pulmonology and Respiratory Care Medicine, Thoraxklinik at the University of Heidelberg, Heidelberg, Germany;4 Translational Lung Research Center Heidelberg, Member of the German Center for Lung Research DZL, Heidelberg, GermanyORCID Iconhttps://orcid.org/0000-0002-7638-2506View further author information
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Jennifer K Quint5 National Heart and Lung Institute, Imperial College London, London, UKORCID Iconhttps://orcid.org/0000-0003-0149-4869View further author information
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Afisi S Ismaila6 Value Evidence and Outcomes, GSK, Collegeville, PA, USA;7 Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, CanadaORCID Iconhttps://orcid.org/0000-0002-2876-8308View further author information
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Pages 643-659 | Received 20 Jan 2023, Accepted 06 Apr 2023, Published online: 19 Apr 2023

Figures & data

Figure 1 Study design.

Abbreviations: BDP, beclomethasone dipropionate; BUD, budesonide; ICS, inhaled corticosteroid; FOR, formoterol fumarate; FP, fluticasone propionate; LABA, long-actingβ2-agonist; SX, salmeterol xinafoate; UMEC, umeclidinium; VI, vilanterol.
Figure 1 Study design.

Table 1 Patient Demographics and Clinical Characteristics

Figure 2 (A) Proportion of patients and (B) odds of adherence (PDC≥80%) at 12 months post-index.

Abbreviations: ATE, average treatment effect; CI, confidence interval; ICS, inhaled corticosteroid; LABA, long-actingβ2-agonist; PCD, proportion of days covered; UMEC, umeclidinium; VI, vilanterol.
Figure 2 (A) Proportion of patients and (B) odds of adherence (PDC≥80%) at 12 months post-index.

Figure 3 Odds of adherence (PDC≥80%) at 6, 18, and 24 months post-index.

Abbreviations: ATE, average treatment effect; CI, confidence interval; ICS, inhaled corticosteroid; LABA, long-actingβ2-agonist; PCD, proportion of days covered; UMEC, umeclidinium; VI, vilanterol.
Figure 3 Odds of adherence (PDC≥80%) at 6, 18, and 24 months post-index.

Figure 4 (A) Time-to-first triple therapy and (B) time-to-first moderate-to-severe COPD exacerbation.

Abbreviations: ATE, average treatment effect; CI, confidence interval; ICS, inhaled corticosteroid; LABA, long-actingβ2-agonist; UMEC, umeclidinium; VI, vilanterol.
Figure 4 (A) Time-to-first triple therapy and (B) time-to-first moderate-to-severe COPD exacerbation.

Figure 5 Rate ratio of (A) COPD-related and (B) all-cause HCRU use at 12 months post-index.

Abbreviations: A&E, Accident and Emergency; ATE, average treatment effect; CI, confidence interval; COPD, chronic obstructive pulmonary disease; GP, general practitioner; HCRU, healthcare resource utilization; ICS, inhaled corticosteroid; LABA, long-actingβ2-agonist; UMEC, umeclidinium; VI, vilanterol.
Figure 5 Rate ratio of (A) COPD-related and (B) all-cause HCRU use at 12 months post-index.

Figure 6 (A) COPD-related and (B) all-cause direct healthcare costs at 12 months post-index.

Abbreviations: ATE, average treatment effect; A&E, Accident and Emergency; CI, confidence interval; COPD, chronic obstructive pulmonary disease; GP, general practitioner; HCRU, healthcare resource utilization; ICS, inhaled corticosteroid; LABA, long-actingβ2-agonist; UMEC, umeclidinium; VI, vilanterol.
Figure 6 (A) COPD-related and (B) all-cause direct healthcare costs at 12 months post-index.

Figure 7 (A) COPD-related and (B) all-cause and total costs at 6, 12, 18, and 24 months post-index.

Abbreviations: ATE, average treatment effect; CI, confidence interval; COPD, chronic obstructive pulmonary disease; HCRU, healthcare resource utilization; ICS, inhaled corticosteroid; LABA, long-actingβ2-agonist; UMEC, umeclidinium; VI, vilanterol.
Figure 7 (A) COPD-related and (B) all-cause and total costs at 6, 12, 18, and 24 months post-index.

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