Pharmacoeconomic efficiency of using the drug budesonide+glycopyrronium bromide+formoterol for the supportive therapy of patients with COPD; Фармакоэкономическая эффективность применения лекарственного препарата будесонид + гликопиррония бромид + формотерол для поддерживающей терапии пациентов с хронической обструктивной болезнью легких

Chronic obstructive pulmonary disease (COPD) is one of the most widespread diseases with a significant socio-economic impact. Nevertheless, properly selected therapy makes it possible to effectively control the course of the disease. Fixed triple combinations are most effective in the severe forms. The list of drugs in this group is constantly expanding, which necessitates selecting the therapeutic approach with an optimal ratio of clinical effectiveness and economic effect of therapy. The aim of the study was to conduct a clinical and economic analysis of the use of a fixed combination of budesonide + glycopyrronium bromide + formoterol (BGF) in patients with COPD receiving triple combinations of long-acting anticholinergic drugs/long-acting β2-agonists/inhaled corticosteroids (LAMA/LABA/ICS). Methods. The triple fixed combination of vilanterol + umeclidinium bromide + fluticasone furoate (VUF) was selected as the active comparison. According to the adjusted indirect comparison data, the relative risk of death associated with BGF was 0.61 (95% CI 0.38 - 0.95) compared to VUF. A mathematical model of the COPD course against the use of the compared alternatives was proposed based on the adjusted indirect comparison data. The model was used to calculate the average number of life years and direct medical costs of the main drug therapy when using the considered alternatives over a modeling horizon of 3 years. Results. The results of modeling the effectiveness of the considered alternatives conclude that therapy with BGF within the 3-year study horizon provides an additional 0.044 years of life compared with the use of VUF. Taking into account the termination of therapy due to death from all causes, the savings will amount to 47,091 rubles when using BGF in a 3-year horizon compared to the use of VUF (108,111 rubles vs 155,202 rubles). Thus, therapy with BGF is more effective and less expensive (dominant therapy). Conclusion. From the perspective of the state payer’s budget, the BGF fixed combination is preferred over VUF for patients with COPD who are candidates for triple therapy and can be recommended for use in the Russian healthcare system. © 2025 Elsevier B.V., All rights reserved.