The NICE guideline on chronic obstructive pulmonary disease (COPD) recommends that the choice of drug treatment should take into account the person's symptomatic response and preference, and the drug's potential to reduce exacerbations, its side effects and costs.
Currently, published efficacy and safety data for fluticasone furoate/vilanterol are limited to short-term, placebo-controlled trials with disease-orientated primary outcomes and 1 study of the effect of fluticasone furoate/vilanterol on rates of moderate and severe exacerbations compared with vilanterol alone. These trials provide no information on the effectiveness of fluticasone furoate/vilanterol compared with available licensed inhaled therapy for COPD.
In addition, the cost of the product has yet to be determined; therefore at present, cost comparisons with other inhaled corticosteroid (ICS)/long-acting beta2 agonist (LABA) combination inhalers licensed for use in COPD cannot be made. At present, the exact place in therapy of fluticasone furoate/vilanterol is difficult to assess but if a UK marketing authorisation is granted, it will represent an additional treatment option alongside existing inhaled therapies licensed for use in COPD.
If a marketing authorisation is granted, the manufacturer expects fluticasone furoate/vilanterol to be used in patients new to this class of drugs or in patients on existing treatments who are symptomatic on their current regimen and may benefit from a once-daily product (GlaxoSmithKline: personal communication March 2013).