Pharmacoeconomic evaluation of triple beclomethasone/glycopyrronium bromide/formoterol combination in the treatment of patients with moderate and severe chronic obstructive pulmonary disease

Objective: To conduct a pharmacoeconomic evaluation of the triple beclomethasone/formoterol/glycopyrronium fixed-dose combination (FDC) for the treatment of patients with moderate and severe chronic obstructive pulmonary disease (COPD) in healthcare institutions of the Moscow Region, Russia.

Material and methods. A pharmacoepidemiological analysis was conducted using data from multiple levels of medical care for patients with COPD in the Moscow Region, including records data from the Territorial Fund for Compulsory Health Insurance (TFCHI) and data on subsidized drug provision. To characterize the frequency and structure of inpatient and outpatient care for COPD, a frequency analysis was performed. Direct costs of COPD pharmacotherapy were assessed, including expenditures associated with triple FDCs. In addition, a budget impact analysis was carried out to evaluate the provision of triple FDCs in a single delivery device.

Results. During the analyzed period, 23,583 COPD patients received inpatient care and 7,314 received outpatient care, with total expenditures of 703,329,560 and 251,189,103 rubles, respectively. Analysis of subsidized drug provision showed that 757 patients (4.2% of all patients receiving COPD therapy) were treated with one of three triple FDCs: beclomethasone/glycopyrronium bromide/ formoterol, budesonide/glycopyrronium bromide/formoterol, or vilanterol/umeclidinium bromide/fluticasone furoate. Budget impact analysis demonstrated that two triple FDCs (budesonide/glycopyrronium bromide/formoterol and beclomethasone/glycopyrronium bromide/formoterol) were associated with identical costs: 2,763.20 rubles per month and 33,158.40 rubles per year. Treatment with the vilanterol/umeclidinium bromide/fluticasone furoate combination was associated with higher costs.

Conclusion. Use of triple FDC of beclomethasone/glycopyrronium bromide/formoterol may help improve compliance to therapy among patients with COPD and is associated with lower costs for the Moscow Region healthcare system. This treatment approach is clinically and economically feasible.

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