COPD Exacerbations, Costs, and Health Care Resource Utilization Before and After Initiation of Fluticasone Furoate/Umeclidinium/Vilanterol in Routine Care in the USA

• Published in: International journal of chronic obstructive pulmonary disease 2023-01, Vol.18, p.407-418
• Main Authors: Hanania, Nicola A, Bunner, Scott H, Bengtson, Lindsay G S, Ismaila, Afisi S, Bogart, Michael
• Format: Article
• Language: English
• Subjects: Administration, Inhalation; Aged; Analysis; Androstadienes - adverse effects; Benzyl Alcohols - adverse effects; Bronchodilator Agents - adverse effects; Chlorobenzenes - adverse effects; Chronic obstructive pulmonary disease; Drug Combinations; Drugstores; Economic aspects; Emergency medical services; exacerbations; Female; ff/umec/vi; Fluticasone - therapeutic use; Health care expenditures; Health care policy; Health care reform; healthcare utilization; Humans; Inhalers; Lung diseases; Lung diseases, Obstructive; Male; Medical care; Medical care, Cost of; Medicare; multiple-inhaler triple therapy; Original Research; Patient Acceptance of Health Care; Patients; Pharmacy; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - drug therapy; Quinuclidines - adverse effects; Respiratory agents; Retrospective Studies; single-inhaler triple therapy; Steroids; Utilization
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S378867

To examine the impact of initiating fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) in a single device on chronic obstructive pulmonary disease (COPD) exacerbations, COPD exacerbation-related costs, and all-cause and COPD-related healthcare resource utilization (HCRU) and costs in patients with COPD. Retrospective database analysis of patients with COPD aged ≥40 years who initiated FF/UMEC/VI between September 1, 2017, and December 31, 2018 (index date: first pharmacy claim for FF/UMEC/VI), following evidence of multiple-inhaler triple therapy (MITT) (≥30 consecutive days) in the year prior to index. COPD exacerbations, COPD exacerbation-related costs, and all-cause and COPD-related HCRU and costs were compared between the baseline period (12 months prior to and including index) and follow-up period (12 months following index). Data from 912 patients (mean [SD] age: 71.2 [8.1], 51.2% female) were included in the analyses. Among the overall cohort, mean count of total COPD exacerbations (moderate or severe) per patient was statistically significantly lower in the follow-up period compared to baseline (1.2 vs 1.4, p=0.001). The proportion of patients with ≥1 COPD exacerbation (moderate or severe) was also statistically significantly lower in the follow-up period compared to baseline (56.4% vs 62.4%, p=0.001). All-cause and COPD-related HCRU were similar during follow-up compared to baseline, although the proportion of patients with COPD-related ambulatory visits was lower during follow-up (p