Potential reductions in COPD exacerbations, mortality, and costs due to increased SITT use in appropriate patients. PROMETHEUS Spain.

<bold>Background:</bold> COPD is the fourth cause of death in Spain. The ETHOS (<ext-link>NCT02465567</ext-link>) and IMPACT (<ext-link>NCT02164513</ext-link>) RCTs have showed reduced exacerbations and all-cause mortality on single-inhaler triple therapy (SITT), but no studies have evaluated broader SITT adoption in Spain. <bold>Aim</bold>: To evaluate the potential impact of higher SITT use on mortality, exacerbations, and their corresponding costs in Spain. <bold>Methods:</bold> We used literature-based data on patient characteristics, incidence, COPD severity changes, treatment distributions/transitions, mortality, exacerbations, and costs, to inform a stochastic simulation of the Spanish COPD population for 2024-2033 under two scenarios: “status quo” and “increased SITT”, in which higher SITT use is driven by airflow limitation, exacerbation history (as per guidelines like GOLD) and SITT replacing multiple-inhaler triple therapy (MITT). <bold>Results:</bold> In our 10-year simulation, increased SITT use reduced all-cause mortality by 15% and decreased severe and moderate exacerbation rates by 15% and 27%, respectively, which resulted in total savings of €957.3 million (<bold>Fig 1</bold>). <bold>Conclusion</bold>: Based on our simulation, increased use of SITT in the Spanish COPD population, consistent with most recent guidelines’ recommendations, could reduce mortality and exacerbations and their corresponding costs. This may constitute a strategy with long-term clinical and economic benefits. <fig><object-id>erj;64/suppl_68/PA1168/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>