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Comparison of Disease Related Healthcare Resource Utilization (HRU) and Costs in Chronic Obstructive Pulmonary Disease (COPD) Patients Receiving Nebulized Long-Acting β2-Agonists (LABAs) FREE TO VIEW

Yaozhu Chen; Charles Maken, MBA; Vamsi Bollu, MBA
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IMS Health, Alexandria, VA

Chest. 2014;146(4_MeetingAbstracts):44A. doi:10.1378/chest.1989842
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SESSION TITLE: COPD Treatment Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: This study compared COPD-related HRU and costs among COPD patients receiving arformoterol or formoterol, the only two FDA approved nebulized LABAs for COPD maintenance.

METHODS: Eligible patients for this retrospective cohort study were identified from the IMS PharMetrics Plus claims database: aged≥35 years, with ≥2 fills of arformoterol or formoterol between 01/01/2008-12/31/2012 (first nebulized LABA defined as index), ≥2 outpatient or ≥1 inpatient claims with COPD diagnosis (ICD-9-CM 491.x, 492.x, 496.x), continuous enrollment 180-day pre- and 360-day post-index, and no nebulized LABA or asthma diagnosis pre-index. Adherence to index drug was computed using proportion of days covered (PDC) in 360-day post-index. To assess the impact of treatment on study outcome, the study was limited to those adherent or partially adherent (A/PA, PDC≥60%) to their index drug. Costs were reported in 2012 USD. Chi-square and t-test/Wilcoxon rank-sum were used for comparison (alpha=0.05). Generalized linear models (GLM) with negative binomial (for HRU) and gamma (for cost) distributions were used to compare the two index cohorts in 360-day post-index, with covariates of demographic and clinical characteristics and pre-index COPD-related healthcare service use.

RESULTS: 417 patients A/PA to their index drug (arformoterol=274, formoterol=143; mean age=70.7, 45% females) were selected. Both cohorts had similar COPD-related HRU across all care settings (inpatient, outpatient, pharmacy). Costs in most settings were similar, except for inpatient care: compared to formoterol users, arformoterol users had significantly lower per-stay cost in those with ≥1 admission (median $9,542 vs. $14,025, p=0.009) or further with ≥1 re-admission within 30 days since discharge (median $7,392 vs. $18,018, p=0.006). Controlling for confounders, arformoterol users were predicted to have 14.4% marginally lower COPD-related total costs than formoterol users (p=0.066). The GLM results also suggest that pre-index COPD-related hospitalization and pre-index use of oral corticosteroids were significant predictors of higher total COPD-related costs.

CONCLUSIONS: In this study on COPD-related burden among A/PA users, patients receiving arformoterol had lower inpatient costs compared to patients receiving formoterol, which led to lower total disease related costs.

CLINICAL IMPLICATIONS: This study suggests that the choice of nebulized LABA may influence economic outcomes, such as some COPD-related costs.

DISCLOSURE: Yaozhu Chen: Employee: IMS Health Charles Maken: Employee: IMS Health Vamsi Bollu: Employee: Sunovion

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