Umeclidinium/Vilanterol vs Tiotropium in COPD

Statins may help decrease mortality in patients with COPD.
Statins may help decrease mortality in patients with COPD.
Which COPD initial maintenance therapy was associated with better adherence by patients and lower COPD-related medical costs?

Real-world evidence supports other data showing that use of umeclidinium/vilanterol (UMEC/VI) as initial maintenance therapy (IMT) in patients with chronic obstructive pulmonary disease (COPD) may reduce medical costs compared with tiotropium (TIO), according to a retrospective study published in BMC Pulmonary Medicine.

UMEC/VI has been associated with lower lifetime medical costs compared with TIO, yet real-world studies have been lacking on the effect of these medications on treatable outcomes, such as COPD exacerbations and medication adherence. In this study, researchers used US claims data from 2014 through 2017 to compare on-treatment exacerbations, medical costs, and medication adherence in patients with COPD who initiated either UMEC/VI or TIO treatment.

Researchers compared matched cohorts for UMEC/VI and TIO, each with 3929 patients. Kaplan–Meier rates for time to first on-treatment overall, moderate and severe COPD-related exacerbation at 12 months were similar between cohorts (hazard ratio [96% CI] overall: 0.93; moderate: 0.92; severe: 1.07; all P >.05). With respect to medication adherence, the UMEC/VI cohort had significantly higher adherence compared with TIO cohort (mean proportion of days covered [PDC]: 0.44 for UMEC/VI vs 0.37 for TIO; P <.001; percentage with PDC ≥ 0.8: 22.0% for UMEC/VI vs 16.4% for TIO; P <.001). The UMEC/VI cohort also had significantly lower mean on-treatment COPD-related total medical costs ($867 vs $1095 per patient per month; P =.028), as driven by lower outpatient visit costs.

“The findings show that compared with TIO, the use of UMEC/VI as IMT may reduce medical costs, possibly through increased adherence to therapy,” concluded the authors. They added, “This provides valuable information for physicians considering IMT options for patients with COPD.”

Disclosure: This research was supported by GSK. Please see the original reference for a full list of disclosures.


Slade D, Ray R, Moretz C, et al. Time-to-first exacerbation, adherence, and medical costs among US patients receiving umeclidinium/vilanterol or tiotropium as initial maintenance therapy for chronic obstructive pulmonary disease: a retrospective cohort study. BMC Pulm Med. 2021;21(1):253.