A US database study characterizing patients initiating a budesonide–formoterol combination versus tiotropium bromide as initial maintenance therapy for chronic obstructive pulmonary disease
David M Kern,1 Setareh A Williams,2 Ozgur Tunceli,1 Catrin Wessman,3 Siting Zhou,1 Ned Pethick,2 Hanaa Elhefni,2 Frank Trudo2 1HealthCore Inc., 2AstraZeneca, Wilmington, DE, USA; 3AstraZeneca, Mölndal, Sweden Objective: To compare clinical and demographic characteristics, resource utilizat...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2014-07-01
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| Series: | International Journal of COPD |
| Online Access: | http://www.dovepress.com/a-us-database-study-characterizing-patients-initiating-a-budesonidenda-peer-reviewed-article-COPD |
| _version_ | 1811275298611658752 |
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| author | Kern DM Williams SA Tunceli O Wessman C Zhou S Pethick N Elhefni H Trudo F |
| author_facet | Kern DM Williams SA Tunceli O Wessman C Zhou S Pethick N Elhefni H Trudo F |
| author_sort | Kern DM |
| collection | DOAJ |
| description | David M Kern,1 Setareh A Williams,2 Ozgur Tunceli,1 Catrin Wessman,3 Siting Zhou,1 Ned Pethick,2 Hanaa Elhefni,2 Frank Trudo2 1HealthCore Inc., 2AstraZeneca, Wilmington, DE, USA; 3AstraZeneca, Mölndal, Sweden Objective: To compare clinical and demographic characteristics, resource utilization and costs of chronic obstructive pulmonary disease (COPD) patients prior to initiating budesonide–formoterol combination (BFC) or tiotropium-maintenance therapy. Materials and methods: This cross-sectional study used claims-based diagnosis to identify COPD patients in the HealthCore Integrated Research Database who initiated BFC or tiotropium therapy between March 1, 2009 and January 31, 2012 (intake period); the index date was defined as the initial prescription fill for either agent. Patients diagnosed with respiratory tract cancer or receiving inhaled corticosteroids/long-acting β2-adrenergic agonists or tiotropium in 12 months prior to index date were excluded. Categorical variables were evaluated with Χ2 tests; mean cost differences were evaluated using γ-regression. Results: Overall, 6,940 BFC and 10,831 tiotropium patients were identified. The BFC group was younger (mean age 64 versus 67 years), with a greater proportion of females (54% versus 51%). BFC-treated patients had more comorbid respiratory conditions, including asthma (25% versus 13%), but fewer comorbid cardiovascular conditions, including atherosclerosis (7% versus 10%) and myocardial infarction (4% versus 6%). A greater proportion of BFC patients received prior respiratory medication, including oral corticosteroids (46% versus 35%) and short-acting β2-agonists (44% versus 35%). Tiotropium-treated patients had a greater mean number of COPD-related outpatient visits (4.6 versus 4.1). BFC-treated patients had lower total all-cause ($17,259 versus $17,926) and COPD-related ($1,718 versus $1,930) health care costs, driven by lower all-cause and COPD-related inpatient expenditures. Conclusion: Initiators of BFC or tiotropium showed differences in clinical and demographic characteristics and health care utilization and costs prior to starting COPD maintenance therapy. Keywords: observational study, retrospective analysis, chronic respiratory condition, outcome research, health care utilization and costs |
| first_indexed | 2024-04-12T23:35:25Z |
| format | Article |
| id | doaj.art-ecaaa0b25062489794219c440e5bfa87 |
| institution | Directory Open Access Journal |
| issn | 1178-2005 |
| language | English |
| last_indexed | 2024-04-12T23:35:25Z |
| publishDate | 2014-07-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of COPD |
| spelling | doaj.art-ecaaa0b25062489794219c440e5bfa872022-12-22T03:12:09ZengDove Medical PressInternational Journal of COPD1178-20052014-07-012014default77578317655A US database study characterizing patients initiating a budesonide–formoterol combination versus tiotropium bromide as initial maintenance therapy for chronic obstructive pulmonary diseaseKern DMWilliams SATunceli OWessman CZhou SPethick NElhefni HTrudo FDavid M Kern,1 Setareh A Williams,2 Ozgur Tunceli,1 Catrin Wessman,3 Siting Zhou,1 Ned Pethick,2 Hanaa Elhefni,2 Frank Trudo2 1HealthCore Inc., 2AstraZeneca, Wilmington, DE, USA; 3AstraZeneca, Mölndal, Sweden Objective: To compare clinical and demographic characteristics, resource utilization and costs of chronic obstructive pulmonary disease (COPD) patients prior to initiating budesonide–formoterol combination (BFC) or tiotropium-maintenance therapy. Materials and methods: This cross-sectional study used claims-based diagnosis to identify COPD patients in the HealthCore Integrated Research Database who initiated BFC or tiotropium therapy between March 1, 2009 and January 31, 2012 (intake period); the index date was defined as the initial prescription fill for either agent. Patients diagnosed with respiratory tract cancer or receiving inhaled corticosteroids/long-acting β2-adrenergic agonists or tiotropium in 12 months prior to index date were excluded. Categorical variables were evaluated with Χ2 tests; mean cost differences were evaluated using γ-regression. Results: Overall, 6,940 BFC and 10,831 tiotropium patients were identified. The BFC group was younger (mean age 64 versus 67 years), with a greater proportion of females (54% versus 51%). BFC-treated patients had more comorbid respiratory conditions, including asthma (25% versus 13%), but fewer comorbid cardiovascular conditions, including atherosclerosis (7% versus 10%) and myocardial infarction (4% versus 6%). A greater proportion of BFC patients received prior respiratory medication, including oral corticosteroids (46% versus 35%) and short-acting β2-agonists (44% versus 35%). Tiotropium-treated patients had a greater mean number of COPD-related outpatient visits (4.6 versus 4.1). BFC-treated patients had lower total all-cause ($17,259 versus $17,926) and COPD-related ($1,718 versus $1,930) health care costs, driven by lower all-cause and COPD-related inpatient expenditures. Conclusion: Initiators of BFC or tiotropium showed differences in clinical and demographic characteristics and health care utilization and costs prior to starting COPD maintenance therapy. Keywords: observational study, retrospective analysis, chronic respiratory condition, outcome research, health care utilization and costshttp://www.dovepress.com/a-us-database-study-characterizing-patients-initiating-a-budesonidenda-peer-reviewed-article-COPD |
| spellingShingle | Kern DM Williams SA Tunceli O Wessman C Zhou S Pethick N Elhefni H Trudo F A US database study characterizing patients initiating a budesonide–formoterol combination versus tiotropium bromide as initial maintenance therapy for chronic obstructive pulmonary disease International Journal of COPD |
| title | A US database study characterizing patients initiating a budesonide–formoterol combination versus tiotropium bromide as initial maintenance therapy for chronic obstructive pulmonary disease |
| title_full | A US database study characterizing patients initiating a budesonide–formoterol combination versus tiotropium bromide as initial maintenance therapy for chronic obstructive pulmonary disease |
| title_fullStr | A US database study characterizing patients initiating a budesonide–formoterol combination versus tiotropium bromide as initial maintenance therapy for chronic obstructive pulmonary disease |
| title_full_unstemmed | A US database study characterizing patients initiating a budesonide–formoterol combination versus tiotropium bromide as initial maintenance therapy for chronic obstructive pulmonary disease |
| title_short | A US database study characterizing patients initiating a budesonide–formoterol combination versus tiotropium bromide as initial maintenance therapy for chronic obstructive pulmonary disease |
| title_sort | us database study characterizing patients initiating a budesonide ndash formoterol combination versus tiotropium bromide as initial maintenance therapy for chronic obstructive pulmonary disease |
| url | http://www.dovepress.com/a-us-database-study-characterizing-patients-initiating-a-budesonidenda-peer-reviewed-article-COPD |
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