Burden of Exacerbations in Patients Newly Initiating an Inhaled Regimen for COPD: A Claims Analysis
Sanjay Sethi1, Emily S Wan2,3, Vickram Tejwani4,5
1Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
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Summary
Despite inhaled treatments, many patients with chronic obstructive pulmonary disease (COPD) still experience exacerbations and healthcare resource utilization (HRU). Further research into guideline-based care and novel therapies is crucial for improving COPD management.
Area of Science:
- Pulmonary Medicine
- Real-World Evidence
- Health Economics
Background:
- Chronic obstructive pulmonary disease (COPD) significantly impacts healthcare resource utilization (HRU).
- Large-scale real-world evidence on the clinical and economic impact of maintenance inhaler therapies for COPD is limited.
Purpose of the Study:
- To evaluate the annual exacerbation rate and COPD-related HRU in patients before and after initiating inhaled treatment.
- To assess the real-world effectiveness of current maintenance inhaler therapies.
Main Methods:
- Utilized the Optum Clinformatics® Data Mart database (January 2016-June 2023) for US patients aged ≥40 with COPD.
- Identified the index date as the first prescription for new inhaled maintenance therapy after a 12-month baseline.
- Assessed exacerbations, inpatient, emergency department (ED), office, and outpatient visits within 12 months post-index.
Main Results:
- Included 137,691 patients; 48.3% initiated long-acting beta-agonists/inhaled corticosteroids (LABA/ICS).
- Exacerbations decreased significantly (45.5% pre-index vs. 37.0% post-index; P < 0.001), yet over one-third experienced exacerbations post-treatment.
- COPD-related HRU generally decreased, with 5.0% having inpatient and 2.9% ED care post-index.
Conclusions:
- Inhaled treatments for COPD do not fully eliminate exacerbations or reduce healthcare resource utilization.
- There is a need for improved guideline-based COPD care and novel therapies to address the persistent burden of exacerbations in real-world settings.