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Browse ATS 2021 Abstracts

HomeProgram ▶ Browse ATS 2021 Abstracts
 

ATS 2021 will feature presentations of original research from accepted abstracts. Mini Symposia and Thematic Poster Sessions are abstract based sessions.

Please use the form below to browse scientific abstracts and case reports accepted for ATS 2021. Abstracts presented at the ATS 2021 will be published in the Online Abstract Issue of the American Journal of Respiratory and Critical Care Medicine, Volume 203, May 3, 2021.

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Projections of Healthcare Resource Utilization and Costs Related to Exacerbations for Budesonide/Glycopyrrolate/Formoterol Fumarate Versus Dual Long-Acting Muscarinic Antagonist/Long-Acting β2-Agonist and Inhaled Corticosteroid/Long-Acting β2‑Agonist Therapies in Moderate-to-Very Severe .

Session Title
TP40 - TP040 COPD CLINICAL TRIALS AND THERAPIES
Abstract
A2249 - Projections of Healthcare Resource Utilization and Costs Related to Exacerbations for Budesonide/Glycopyrrolate/Formoterol Fumarate Versus Dual Long-Acting Muscarinic Antagonist/Long-Acting β2-Agonist and Inhaled Corticosteroid/Long-Acting β2‑Agonist Therapies in Moderate-to-Very Severe Chronic Obstructive Pulmonary Disease
Author Block: E. De Nigris1, C. Treharne2, N. Brighton2, U. Holmgren3, A. Walker4, J. Haughney5; 1AstraZeneca, Cambridge, United Kingdom, 2Parexel International, London, United Kingdom, 3AstraZeneca, Gothenburg, Sweden, 4Salus Alba, Glasgow, United Kingdom, 5Clinical Research Facility, Queen Elizabeth University Hospital, Glasgow, United Kingdom.
Rationale: Chronic obstructive pulmonary disease (COPD) causes a considerable societal and economic burden and generates an estimated $50 billion/year cost to US healthcare, attributed mostly to exacerbations. The ETHOS trial (NCT02465567) demonstrated the efficacy of budesonide/glycopyrrolate/formoterol fumarate (BGF) 320/18/9.6μg triple therapy versus long-acting muscarinic antagonist (LAMA)/long-acting β2-agonist (LABA) and inhaled corticosteroid (ICS)/LABA dual therapies in improving lung function, quality of life and symptoms, and reducing the moderate/severe exacerbation rate over 52 weeks.1 ETHOS trial data was extrapolated over a patient’s lifetime to estimate long-term exacerbation-related healthcare resource utilization (HCRU) and costs to assess the impact of BGF on healthcare budgets. Methods: Using ETHOS data and published literature, a semi-Markov model was developed to simulate the natural history of patients recruited in the trial. Health states were defined based on airflow limitation (forced expiratory volume in 1 second % predicted; moderate/severe/very severe) and exacerbation history (none/moderate/severe). Probabilities for transitions between COPD severity states and exacerbation rates were estimated from ETHOS. Resources used to treat an exacerbation were estimated from ETHOS HCRU data for severe and moderate exacerbations (Table). Costs per HCRU unit came from the UK National Health Service reference costs and Personal Social Services Research Unit health, and social care cost units. Outcomes included average HCRU and costs related to moderate and severe exacerbations per patient in a UK COPD population receiving BGF versus dual therapies. All estimates are reported in GBP (with USD equivalents). Results: Average per-patient lifetime costs of exacerbations over 30 years were £6,448 ($8,576) for BGF 320, £7,664 ($10,193) for LAMA/LABA and £9,568 ($12,725) for ICS/LABA. Based on UK epidemiological data (3.33% of the total UK population with COPD, 9.99% of patients on triple therapy) and the assumption of 5% of patients with COPD receiving BGF, we estimated exacerbations lifetime cost savings for BGF of more than £14 million ($19 million) versus LAMA/LABA and £35 million ($47 million) versus ICS/LABA (equivalent HCRUs in Table). The greatest lifetime cost savings in HCRUs for BGF versus both LAMA/LABA and ICS/LABA were seen in hospitalizations to a general ward for the treatment of severe exacerbations (Table). Conclusion: Modeling using ETHOS data demonstrated exacerbation-related cost savings with BGF triple therapy versus dual therapies over a lifetime for patients with moderate-to-very severe COPD. 1. Rabe et al. NEJM 2020; 383:35-48.