SESSION TITLE: COPD Treatment Posters
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM
PURPOSE: Long-acting muscarinic antagonists (LAMA) are typically prescribed for patients with moderate to severe Chronic Obstructive Pulmonary Disease (COPD). COPD patients receiving LAMA monotherapy continue to show significant symptoms, exacerbations and poor quality of life. The goal of this study was to compare healthcare resource use, costs and treatment patterns among patients newly initiated (incident) on LAMA versus existing (prevalent) LAMA users.
METHODS: Retrospective, observational study design utilizing administrative claims from health plans (study period 07/2007-7/2011). All COPD patients on LAMA therapy with age ≥40 years were included. COPD patients without LAMA prescription in the 12 months prior to index date were classified incident LAMA users. Comparisons across incident and prevalent LAMA users were performed on outcomes including COPD related medication use, spirometry use, dyspnea, home oxygen therapy, health care resource utilization and cost for one year post index period. Generalized Linear Model was used to estimate adjusted total COPD-related costs for incident and prevalent LAMA users.
RESULTS: A total of 5,311 patients were identified with mean(±SD) age of 62(±10) years. Prevalent LAMA users had higher SABA (50.8% vs. 47.8%, p-value <0.05) and home oxygen therapy use (8.5% vs. 5%, p-value <0.01) as compared to incident LAMA users in the post-index period. Incident LAMA patients had higher rates of spirometry use (33.8% vs. 30%, p-value <0.01). Prevalent LAMA cases had higher rates of medication use, specifically - ICS (11.5% vs. 9.5%, p-value <0.05), ICS/LABA (47% vs. 39.5%, p-value <0.01) and LABA (6% vs. 2.4%, p-value <0.01) than incident LAMA users in post index period. After adjusting for covariates, prevalent LAMA cases had higher COPD related healthcare costs ($3688 vs. $2468, p-value <0.05) in the 12 month post index.
CONCLUSIONS: After adjusting for COPD symptoms and proxy measures of severity, COPD related costs were higher for prevalent LAMA users compared to incident LAMA users.
CLINICAL IMPLICATIONS: These study findings highlight the unmet need for COPD patients that have been a long term LAMA user.
DISCLOSURE: Saurabh Nagar: Employee: GlaxoSmithKline Anand Dalal: Employee: GlaxoSmithKline Jeetvan Patel: Employee: GlaxoSmithKline
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