PRS24 - Observational Study of The Outcomes and Costs Of Initiating Inhaled Long-Acting Bronchodilators Versus Inhaled Short-Acting Bronchodilators Therapies In Newly-Diagnosed Copd Patients

Abstract

The aim of this study was to examine the association between inhaled bronchodilators and the utilization of healthcare services in newly-diagnosed COPD patients using a nationalwide health insurance administrative databases. The Taiwan National Health Insurance Research Databases were used. Participants ≧40-years-old who had not been diagnosed with COPD between 2006 and 2007 but were diagnosed and prescribed COPD medications in 2008 were recruited as newly diagnosed COPD patients. Patients were categorized into three groups depending on their medications use, an inhaled long-acting bronchodilator (ILA-B), an inhaled short-acting bronchodilator (ISA-B) and an oral respiratory medication (ORM) group. The risk of COPD emergency department visits, hospitalization and healthcare costs were compared among cohorts during 1 year of follow-up. A total of 13,181 newly-diagnosed COPD patients with a mean age of 65.2 years, among which 8,055 (60.7%) were men, were included in the study. ED visits and hospitalization were associated with ISA-B cohort, male gender, older age, copayment exemptions, tertiary healthcare institutions visits, non-pulmonary specialist physicians and higher comorbidities. Multivariate analysis showed that the ISA-B cohort was associated with more ED visits, recurrent ED visits, hospitalizations and rehospitalizations (adjusted ORs [95% confidence intervals] = 5.06 [3.46, 7.41], 3.98 [2.08, 7.58], 1.59 [1.18, 2.21], and 1.42 [1.19, 2.18], respectively) compared with the ILA-B cohort. The ILA-B cohort incurred significantly higher adjusted pharmacy costs per patient per year by $165 (95% CI: $97, $233; P<0.001) vs the ISA-B cohort, whereas adjusted medical costs per patient per year were significantly lower in the ILA-B cohort vs the ISA-B cohort ($348 vs $564; P<0.001). The total yearly adjusted costs per patient, as a result, did not differ significantly between this two cohorts. Initiation of Inhaled long-acting bronchodilator treatment was associated with better clinical and economic outcomes compared to inhaled short-acting bronchodilator in newly-diagnosed COPD patients in real-life clinical practice.