OBJECTIVES:

To investigate all-cause and chronic obstructive pulmonary disease (COPD)-related health care resource utilisation (HCRU) and direct medical costs in patients with COPD before and after switching from multiple-inhaler triple therapy (MITT) to once-daily single-inhaler triple therapy (SITT) fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI).

METHODS:

A retrospective analysis of linked English primary and secondary care data. Patients aged ≥35 years, with a COPD diagnosis, linkage to secondary care data and GP registration for 12 months pre- (baseline) and 6 months post-index (follow-up), were indexed on initiation of FF/UMEC/VI immediately following MITT. Rate of HCRU and mean total medical costs were compared between baseline and follow-up for all patients and those with recent exacerbation.

RESULTS:

2675 patients were included (mean age 71.1 [SD 9.8] years, 52.2% male).

Post-switch, patients had significantly fewer COPD-related primary care attendances (RR 0.67, 95% CI 0.65–0.70), inpatient stays (RR 0.82, 0.73–0.92) and emergency department (ED) attendances (RR 0.71, 0.62–0.82) and lower total costs (£961 pre-switch vs £729 post-switch, p<0.0001). All-cause primary care attendances were significantly lower (RR 0.96, 0.94–0.97) post-switch. All-cause inpatient stays, ED attendances and total costs were not significantly different. Among patients with ≥1 exacerbation during baseline, COPD-related primary care attendances (RR 0.67, 0.64–0.70), inpatient stays (RR 0.65, 0.57–0.74), ED attendances (RR 0.60, 0.52–0.70) and total costs (£1609 pre-switch vs £1104 post-switch, p<0.0001) were significantly lower post-switch. All-cause primary care attendances (RR 0.93, 0.91–0.96), inpatient stays (RR 0.88, 0.81–0.96) and ED attendances (RR 0.82, 0.75–0.90) were also significantly lower. All-cause total costs were not significantly different.

CONCLUSIONS:

COPD patients who switched from MITT to once-daily SITT FF/UMEC/VI had lower COPD-related HCRU and costs 6-months following the switch compared with 6-months pre-switch. The long-term benefits of switching from MITT to SITT requires further investigation.

Funding: GSK 218242