Costs, exacerbations and pneumonia after initiating combination tiotropium olodaterol versus triple therapy for chronic obstructive pulmonary disease

J Comp Eff Res. 2019 Nov;8(15):1299-1316. doi: 10.2217/cer-2019-0101. Epub 2019 Sep 27.

Abstract

Aim: To compare health plan-paid costs, exacerbations and pneumonia outcomes for patients with chronic obstructive pulmonary disease (COPD) initiating combination tiotropium olodaterol (TIO + OLO) versus triple therapy (TT: long-acting muscarinic antagonist + long-acting β2 agonists + inhaled corticosteroid). Patients & methods: COPD patients initiating TIO + OLO or TT between 1 January 2014 and 30 June 2016 were identified from a managed care Medicare database and balanced for baseline characteristics using inverse probability of treatment weighting before assessment of outcomes. Results: Annual COPD-related and all-cause costs were US$4118 (35%) and US$5384 (23%) lower for TIO + OLO versus TT (both p ≤ 0.001). TIO + OLO patients had nearly half the severe exacerbations (8.3 vs 15.5%; p = 0.014) and pneumonia was also less common (18.9 vs 30.9%; p < 0.001). Conclusion: TIO + OLO was associated with improved economic and COPD health outcomes versus TT.

Keywords: COPD exacerbation; healthcare costs; healthcare resource use; pneumonia; tiotropium olodaterol; triple therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Cortex Hormones / economics
  • Adrenal Cortex Hormones / therapeutic use
  • Adrenergic beta-2 Receptor Agonists / economics
  • Adrenergic beta-2 Receptor Agonists / therapeutic use
  • Adult
  • Aged
  • Aged, 80 and over
  • Benzoxazines / economics
  • Benzoxazines / therapeutic use*
  • Bronchodilator Agents / administration & dosage
  • Bronchodilator Agents / economics
  • Bronchodilator Agents / therapeutic use*
  • Disease Progression
  • Drug Combinations
  • Drug Therapy, Combination
  • Female
  • Health Expenditures / statistics & numerical data
  • Humans
  • Insurance Claim Review
  • Male
  • Medicare / economics
  • Medicare / statistics & numerical data
  • Middle Aged
  • Models, Economic
  • Muscarinic Antagonists / economics
  • Muscarinic Antagonists / therapeutic use
  • Pneumonia / economics
  • Pneumonia / etiology*
  • Pulmonary Disease, Chronic Obstructive / complications*
  • Pulmonary Disease, Chronic Obstructive / drug therapy*
  • Pulmonary Disease, Chronic Obstructive / economics
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Tiotropium Bromide / economics
  • Tiotropium Bromide / therapeutic use*
  • Treatment Outcome
  • United States

Substances

  • Adrenal Cortex Hormones
  • Adrenergic beta-2 Receptor Agonists
  • Benzoxazines
  • Bronchodilator Agents
  • Drug Combinations
  • Muscarinic Antagonists
  • tiotropium-olodaterol
  • Tiotropium Bromide