Adherence and Persistence with Single-Inhaler Triple Therapy Among Patients with COPD Using Commercial and Medicare Advantage US Health Plan Claims Data

IF 3.4 3区医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in Therapy Pub Date : 2024-12-05 DOI:10.1007/s12325-024-03055-w

Corinne Young, Lydia Y. Lee, Kristi K. DiRocco, Guillaume Germain, Jacob Klimek, François Laliberté, Dominique Lejeune, Stephen G. Noorduyn, Rosirene Paczkowski

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引用次数: 0

Abstract

Introduction

Previously, adherence and persistence to treatment have been shown to improve outcomes among patients with chronic obstructive pulmonary disease (COPD). This study aimed to evaluate adherence and persistence to single-inhaler triple therapy with fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI; one inhalation, once-daily) compared with budesonide/glycopyrrolate/formoterol fumarate (BUD/GLY/FOR; two inhalations, twice-daily) among patients with COPD in the USA.

Methods

This retrospective weighted cohort study used claims data from the IQVIA PharMetrics^® Plus Database from October 1, 2019 to March 31, 2023, to identify patients with COPD newly initiating FF/UMEC/VI or BUD/GLY/FOR. Index date was the first pharmacy claim for FF/UMEC/VI or BUD/GLY/FOR on or after October 1, 2020. The longest follow-up period was 12 months. Inverse probability of treatment weighting was used to balance baseline characteristics between cohorts. Adherence was measured as mean proportion of days covered (PDC); the proportion of patients with PDC ≥ 0.5 and PDC ≥ 0.8 was also assessed. Persistence was assessed as time to treatment discontinuation using Kaplan–Meier rates.

Results

Overall, 8912 and 2685 patients were included in the FF/UMEC/VI and BUD/GLY/FOR cohorts, respectively. After weighting, mean age and proportion of patients with Medicare Advantage insurance was 64.62 years and 40.0% in the FF/UMEC/VI cohort and 63.96 years and 36.1% in the BUD/GLY/FOR cohort. At 6 months post-index, mean PDC was greater in the FF/UMEC/VI versus the BUD/GLY/FOR cohort (0.65 versus 0.59; P < 0.001). A significantly greater proportion of patients in the FF/UMEC/VI versus the BUD/GLY/FOR cohort had PDC ≥ 0.8 (45.6% versus 34.5%; P < 0.001) and PDC ≥ 0.5 (71.8% versus 64.3%; P < 0.001). Results were consistent at 12 months post-index. When a 30-day gap was used to define treatment discontinuation, the FF/UMEC/VI cohort had statistically significantly greater treatment persistence versus the BUD/GLY/FOR cohort at all time points.

Conclusion

In this study, patients initiating FF/UMEC/VI had significantly greater adherence and persistence to treatment than patients initiating BUD/GLY/FOR.

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使用商业和医疗保险优势美国健康计划索赔数据的COPD患者单吸入器三联疗法的依从性和持久性

先前，坚持和坚持治疗已被证明可以改善慢性阻塞性肺疾病（COPD）患者的预后。本研究旨在评估糠酸氟替卡松/乌莫替啶/维兰特罗单吸入三联疗法(FF/UMEC/VI；布地奈德/甘罗酸酯/富马酸福莫特罗(BUD/GLY/FOR；2次吸入，每日2次)。方法：这项回顾性加权队列研究使用来自IQVIA PharMetrics®Plus数据库2019年10月1日至2023年3月31日的索赔数据，以确定新发FF/UMEC/VI或BUD/GLY/FOR的COPD患者。索引日期为2020年10月1日或之后FF/UMEC/VI或BUD/GLY/ for的首次药房索赔。最长随访期为12个月。使用治疗加权的逆概率来平衡队列之间的基线特征。依从性以平均覆盖天数比例（PDC）衡量；同时评估PDC≥0.5和PDC≥0.8的患者比例。使用Kaplan-Meier率评估持续治疗至停止治疗的时间。结果：总体而言，FF/UMEC/VI和BUD/GLY/FOR队列分别纳入8912例和2685例患者。加权后，FF/UMEC/VI队列患者的平均年龄和比例分别为64.62岁和40.0%，BUD/GLY/FOR队列患者的平均年龄和比例分别为63.96岁和36.1%。在指数后6个月，FF/UMEC/VI组的平均PDC高于BUD/GLY/FOR组(0.65 vs 0.59；结论：在本研究中，FF/UMEC/VI初始化患者的治疗依从性和持久性明显高于BUD/GLY/FOR初始化患者。

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来源期刊

Advances in Therapy 医学-药学

CiteScore

7.20

自引率

2.60%

发文量

353

审稿时长

6-12 weeks

期刊介绍： Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.