TABLE 3.
Post-initiation Health Care Costs
| Health Care Costs | BFC, $ (n = 3,697) | FSC (Reference), $ (n = 3,697) | AMD,a $ | 95% CLs, $ | P Value | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| Mean | SD | Median | Mean | SD | Median | Lower | Upper | |||
| All-cause health care costsb | ||||||||||
| Total all-cause costs | 21,580 | 46,376 | 10,255 | 24,483 | 45,324 | 11,186 | -1,884 | -2,685 | -1,047 | < 0.001 |
| All-cause medical costs | 16,943 | 45,139 | 5,574 | 19,619 | 44,030 | 6,487 | -1,729 | -2,513 | -898 | < 0.001 |
| Inpatient hospitalization | 8,519 | 38,072 | 0 | 10,314 | 34,708 | 0 | -1,242 | -2,082 | -288 | 0.012 |
| Emergency department | 621 | 1,903 | 0 | 675 | 2,306 | 0 | -12 | -65 | 47 | 0.670 |
| Outpatient/office visit | 7,310 | 16,440 | 3,827 | 7,921 | 17,873 | 3,911 | -464 | -778 | -135 | 0.006 |
| Other medicalc | 494 | 3,147 | 0 | 710 | 3,602 | 0 | 34 | -3 | 75 | 0.076 |
| All-cause pharmacy costs | 4,637 | 6,141 | 3,205 | 4,864 | 5,710 | 3,465 | -67 | -200 | 71 | 0.339 |
| COPD-related health care costsb | ||||||||||
| Total COPD-related costs | 4,326 | 9,267 | 2,165 | 4,846 | 9,627 | 2,433 | -316 | -512 | -108 | 0.003 |
| COPD-related medical costs | 2,843 | 8,927 | 508 | 3,236 | 9,274 | 584 | -252 | -432 | -57 | 0.012 |
| Inpatient hospitalization | 966 | 6,915 | 0 | 1,202 | 7,688 | 0 | -248 | -337 | -147 | < 0.001 |
| Emergency department | 257 | 1,120 | 0 | 252 | 1,119 | 0 | 26 | 2 | 52 | 0.033 |
| Outpatient/office visit | 1,378 | 3,322 | 396 | 1,436 | 2,852 | 434 | -97 | -186 | -1 | 0.048 |
| Other medicalc | 243 | 1,815 | 0 | 346 | 2,167 | 0 | -15 | -32 | 3 | 0.101 |
| COPD-related pharmacy costs | 1,482 | 1,634 | 947 | 1,609 | 1,712 | 1,105 | -121 | -193 | -45 | 0.002 |
| Pneumonia-related health care costsb,d | ||||||||||
| Pneumonia-related medical costs | 2,855 | 32,237 | 0 | 3,605 | 23,095 | 0 | -716 | -967 | -431 | < 0.001 |
| Inpatient hospitalization | 2,728 | 32,033 | 0 | 3,409 | 22,880 | 0 | -640 | -894 | -349 | < 0.001 |
| Emergency department | 20 | 291 | 0 | 26 | 287 | 0 | 0 | -2 | 2 | 0.691 |
| Outpatient/office visit | 57 | 346 | 0 | 78 | 557 | 0 | -11 | -14 | -7 | < 0.001 |
| Other medicalc | 51 | 951 | 0 | 93 | 1,310 | 0 | 0 | -4 | 4 | 0.894 |
aAdjusted mean differences are from gamma regression models (link = log). Statistical comparisons are comparing BFC with FSC (reference group); i.e., mean difference = mean (BFC)–mean (FSC). Model covariates include sum of inpatient hospital stays > 5 days (0 vs. 1), leukotriene receptor antagonist use (0, 1, 2+), geographic region, peripheral vascular disease/atherosclerosis (0 vs. 1), index prescribing physician specialty, and analogous pre-index cost variable (log-transformed to normalize).
b$0 costs were manipulated to $1 for the gamma regression model; all costs were adjusted for calendar year, reported in 2012 U.S. dollars.
cOther medical costs include skilled nursing facility costs. dICD-9-CM diagnosis codes used to identify pneumonia include viral pneumonia (480.xx), bacterial pneumonia (481.xx-485.xx), and other/unspecified pneumonia (486.xx).
AMD = adjusted mean difference; BFC = budesonide/formoterol; CL = confidence limit; COPD = chronic obstructive pulmonary disease; FSC = fluticasone/salmeterol; ICD-9-CM = International Classification of Diseases, Ninth Revision, Clinical Modification; SD = standard deviation.