COPD-related healthcare utilization and costs after discharge from a hospitalization or emergency department visit on a regimen of fluticasone propionate-salmeterol combination versus other maintenance therapies.
Am J Manag Care. 2011 Mar;17(3):e55-65
Authors: Dalal AA, Shah M, D'Souza AO, Mapel DW
Abstract
OBJECTIVES: To quantify healthcare use and costs associated with chronic obstructive pulmonary disease (COPD) among patients discharged from a COPD-related hospitalization or emergency department (ED) visit on a regimen of fluticasone propionate-salmeterol combination versus other inhaled maintenance therapies.
STUDY DESIGN: Retrospective cohort study.
METHODS: Managed care enrollees with an index hospitalization (with a primary or secondary [ie, in the second position] diagnosis of COPD) or ED visit (with a primary diagnosis of COPD) were identified for placement into study cohorts during a 60-day period following the index date. Time to COPD-related events and healthcare costs were compared during up to 1 year of follow-up between the 2 cohorts.
RESULTS: The sample comprised 5677 patients (1291 in the fluticasone propionate-salmeterol cohort and 4386 in the other maintenance therapies cohort). The adjusted rate of COPD-related hospitalizations or ED visits was 35% lower in the fluticasone propionate-salmeterol cohort (P <.05). Adjusted COPD-related total (medical plus pharmacy) costs were lower in the fluticasone propionate-salmeterol cohort ($240 vs $279 per patient per month, P <.05), mostly because of lower medical costs ($113 vs $160 per patient per month, P <.05). Pharmacy costs did not differ between fluticasone propionate-salmeterol and other maintenance therapies. Results were similar in the subset of patients 65 years or older.
CONCLUSIONS: Initiation of fluticasone propionate-salmeterol after discharge from a COPD-related hospitalization or ED visit significantly reduced the risk of a recurrent event during the ensuing months and decreased COPD-related medical costs, without an increase in COPD-related pharmacy costs, in a real-world setting.
PMID: 21504260 [PubMed - indexed for MEDLINE]