The Impact Of Fluticasone Furoate/Vilanterol On Healthcare Resource Utilisation In The Salford Lung Study In Chronic Obstructive Pulmonary Disease

THERAPEUTIC ADVANCES IN RESPIRATORY DISEASE(2021)

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Aim:The Salford Lung Study (SLS) in chronic obstructive pulmonary disease (COPD) was a randomised controlled trial evaluating the effectiveness and safety of initiating fluticasone furoate/vilanterol (FF/VI) 100/25 mu g versus continuing usual care (UC) in patients with COPD and a history of exacerbations. Here, we investigate the impact of initiating FF/VI on healthcare resource utilisation (HRU) in SLS COPD.Methods:HRU and interventions were determined from patients' electronic health records. Annual rates of on-treatment all-cause and COPD-related secondary care contacts (SCCs) and primary care contacts (PCCs) for FF/VI versus UC were analysed using a general linear model. Costs were derived from national data sources.Results:Least-squares (LS) mean annual rates of all-cause (9.81 versus 9.36) and COPD-related (1.57 versus 1.48) SCCs were similar for FF/VI and UC, as were rates of all-cause hospitalisations (0.87 versus 0.82). Mean duration of hospital stay/patient was 4.5 and 4.2 days, respectively. COPD-related SCC mean total cost/patient was 484 pound FF/VI and 475 pound UC. LS mean annual rates of all-cause PCCs were significantly higher for FF/VI (21.20 versus 18.88 UC; p < 0.001). LS mean annual rates of COPD-related PCCs were similar for FF/VI and UC (2.42 versus 2.46). All-cause PCC mean total cost/patient was 900 pound FF/VI versus 811 pound UC, but COPD-related PCC costs were similar (116 pound versus 114) pound. Direct COPD-related total medical costs/patient were significantly lower for FF/VI (LS geometric mean 806 pound versus 963 pound UC; p < 0.001).Discussion:In patients with COPD and exacerbation history, FF/VI may represent a less costly alternative to current therapies.GlaxoSmithKline plc. study HZC115151; ClinicalTrials.gov NCT01551758.The reviews of this paper are available via the supplemental material section.
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COPD, effectiveness, fluticasone furoate, healthcare resource utilisation, usual care, vilanterol
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