Table 3.
Unadjusted COPD-related health care utilization and costs associated with initial maintenance therapies in the one-year follow-up period (“cost population”)
| FSC (n = 12,595) | Ipratropium (n = 10,617) | P valuea | Tiotropium (n = 9126) | P valuea | |
|---|---|---|---|---|---|
| COPD medication utilization | |||||
| Medication possession ratio for primary initial maintenance therapy medication (mean, SD) | 32% (28%) | 22% (23%) | <0.001 | 41% (33%) | <0.001 |
| Alternate maintenance therapy, n (%) | |||||
| FSC | na | 795 (7.5) | – | 839 (9.2) | – |
| Ipratropium | 713 (5.7) | na | – | 461 (5.1) | <0.001 |
| Tiotropium | 956 (7.6) | 790 (7.4) | <0.876 | na | – |
| Any alternate maintenance therapy | 1571 (12.5) | 1367 (12.9) | 0.560 | 1208 (13.2) | 0.187 |
| SABA prescription fills, mean (SD) | 1.44 (2.90) | 0.81 (2.45) | <0.001 | 1.48 (3.13) | 0.4029 |
| COPD-related health care utilization, n (%) | |||||
| Hospitalization | 446 (3.5) | 651 (6.1) | <0.001 | 413 (4.5) | <0.001 |
| Outpatient visit w/oral corticosteroid | 261 (2.1) | 354 (3.3) | <0.001 | 262 (2.9) | <0.001 |
| Outpatient visit with antibiotic | 490 (3.9) | 617 (5.8) | <0.001 | 478 (5.2) | <0.001 |
| Emergency department visit | 450 (3.6) | 778 (7.3) | <0.001 | 427 (4.7) | <0.001 |
| Outpatient visit | 3615 (28.7) | 3788 (35.7) | <0.001 | 3661 (40.1) | <0.001 |
| Hospitalization/emergency department visit | 819 (6.5) | 1284 (12.1) | <0.001 | 764 (8.4) | <0.001 |
| COPD-related health care utilization, mean (SD) | |||||
| Outpatient visit | 0.76 (2.24) | 1.28 (3.13) | <0.001 | 1.26 (3.14) | <0.001 |
| Outpatient visit with oral corticosteroid | 0.03 (0.27) | 0.05 (0.33) | <0.001 | 0.04 (0.28) | 0.0153 |
| Outpatient visit with antibiotic | 0.05 (0.32) | 0.08 (0.40) | <0.001 | 0.07 (0.37) | <0.001 |
| Emergency department visit | 0.04 (0.28) | 0.09 (0.37) | <0.001 | 0.06 (0.28) | 0.0044 |
| Hospitalization | 0.04 (0.24) | 0.08 (0.34) | <0.001 | 0.06 (0.29) | 0.0011 |
| Hospitalization/emergency department visit | 0.09 (0.40) | 0.17 (0.55) | <0.001 | 0.11 (0.44) | <0.001 |
| COPD-related health care costs, mean (SD) | |||||
| Medicalb | $1058 ($7545) | $2179 ($12,094) | <0.001 | $1485 ($9489) | 0.001 |
| Pharmacyc | $960 ($1040) | $630 ($945) | <0.001 | $968 ($949) | 0.551 |
| Total | $2018 ($7658) | $2809 ($12,219) | <0.001 | $2453 ($9588) | 0.001 |
Notes:
a
For difference with FSC cohort;
b
Medical costs include outpatient, emergency department, and inpatient care;
c
Pharmacy costs include all outpatient prescription medication costs (includes cost of study medication as well as other COPD medications dispensed after the 60-day postindex date window).
Abbreviations: FSC, fluticasone propionate/salmeterol combination; na, not applicable; SABA, short-acting beta-agonist; SD, standard deviation; COPD, chronic obstructive pulmonary disease.