OBJECTIVE: To assess the association between adherence with fluticasone propionate/salmeterol combination (FSC) product in a single inhaler and asthma care utilization and costs in asthma patients in typical US clinical practice. METHODS: Retrospective longitudinal analysis using linked medical and pharmacy claims from a managed care database representing >70 US health plans. Subjects included those with two prescriptions for FSC after January 1, 2000 (first prescription = 'index date') and diagnosis of asthma. Follow-up was defined as time from index date to disenrollment or discontinuation of FSC (180 days without supply), receipt of different controller, or 24 months post-index. Patients were excluded if: <12 months continuous enrollment pre-index, <12 months of follow-up, diagnoses of COPD or respiratory cancer, use of ipratropium, or age <12 years. Effect of FSC adherence on asthma-related outcomes (short-acting beta-agonist use (SABA), corticosteroid use (CS), emergency department (ED) visit/hospitalizations) and asthma-related health plan costs during each quarter post-index and FSC adherence in prior quarter controlling for demographics, time since index, season, comorbidities, pre-index medications, utilization, and cost. RESULTS: 12 907 patients were identified: mean age, 40 years; mean follow-up, 20 months; mean quarterly FSC adherence, 54%; mean quarterly incidence of asthma-related ED visit/hospitalization, 1.12%. After adjusting for baseline characteristics, each 25% improvement in adherence was associated with a 10% reduction in the odds of asthma-related ED visit or hospitalization (p < 0.001), a 10% reduction in the odds of receiving SABA (p < 0.001), a 3% reduction in the odds of receiving a CS (p = 0.027). However, total asthma-related costs also increased 23% for each 25% increase in the use of FSC. CONCLUSIONS: Despite the limitations of the study, this analysis shows that improving compliance with an asthma controller medication such as FSC may help reduce the burden of asthma.
OBJECTIVE: To assess the association between adherence with fluticasone propionate/salmeterol combination (FSC) product in a single inhaler and asthma care utilization and costs in asthma patients in typical US clinical practice. METHODS: Retrospective longitudinal analysis using linked medical and pharmacy claims from a managed care database representing >70 US health plans. Subjects included those with two prescriptions for FSC after January 1, 2000 (first prescription = 'index date') and diagnosis of asthma. Follow-up was defined as time from index date to disenrollment or discontinuation of FSC (180 days without supply), receipt of different controller, or 24 months post-index. Patients were excluded if: <12 months continuous enrollment pre-index, <12 months of follow-up, diagnoses of COPD or respiratory cancer, use of ipratropium, or age <12 years. Effect of FSC adherence on asthma-related outcomes (short-acting beta-agonist use (SABA), corticosteroid use (CS), emergency department (ED) visit/hospitalizations) and asthma-related health plan costs during each quarter post-index and FSC adherence in prior quarter controlling for demographics, time since index, season, comorbidities, pre-index medications, utilization, and cost. RESULTS: 12 907 patients were identified: mean age, 40 years; mean follow-up, 20 months; mean quarterly FSC adherence, 54%; mean quarterly incidence of asthma-related ED visit/hospitalization, 1.12%. After adjusting for baseline characteristics, each 25% improvement in adherence was associated with a 10% reduction in the odds of asthma-related ED visit or hospitalization (p < 0.001), a 10% reduction in the odds of receiving SABA (p < 0.001), a 3% reduction in the odds of receiving a CS (p = 0.027). However, total asthma-related costs also increased 23% for each 25% increase in the use of FSC. CONCLUSIONS: Despite the limitations of the study, this analysis shows that improving compliance with an asthma controller medication such as FSC may help reduce the burden of asthma.
Authors: Emmanuelle M Clerisme-Beaty; Susan J Bartlett; W Gerald Teague; John Lima; Charles G Irvin; Rubin Cohen; Mario Castro; Robert A Wise; Cynthia S Rand Journal: J Allergy Clin Immunol Date: 2011-02 Impact factor: 10.793
Authors: Elliot Israel; Juan Carlos Cardet; Jennifer K Carroll; Anne L Fuhlbrigge; Wilson D Pace; Nancy E Maher; Lilin She; Frank W Rockhold; Maureen Fagan; Victoria E Forth; Paulina Arias Hernandez; Brian K Manning; Jacqueline Rodriguez-Louis; Joel B Shields; Tamera Coyne-Beasley; Barbara M Kaplan; Cynthia S Rand; Wilfredo Morales-Cosme; Michael E Wechsler; Juan P Wisnivesky; Mary White; Barbara P Yawn; M Diane McKee; Paula J Busse; David C Kaelber; Sylvette Nazario; Michelle L Hernandez; Andrea J Apter; Ku-Lang Chang; Victor Pinto-Plata; Paul M Stranges; Laura P Hurley; Jennifer Trevor; Thomas B Casale; Geoffrey Chupp; Isaretta L Riley; Kartik Shenoy; Magdalena Pasarica; Rafael A Calderon-Candelario; Hazel Tapp; Ahmet Baydur Journal: Contemp Clin Trials Date: 2020-12-11 Impact factor: 2.226
Authors: Rachelle Louise Cutler; Fernando Fernandez-Llimos; Michael Frommer; Charlie Benrimoj; Victoria Garcia-Cardenas Journal: BMJ Open Date: 2018-01-21 Impact factor: 2.692
Authors: Rajan Merchant; Stanley J Szefler; Bruce G Bender; Michael Tuffli; Meredith A Barrett; Rahul Gondalia; Leanne Kaye; David Van Sickle; David A Stempel Journal: World Allergy Organ J Date: 2018-12-03 Impact factor: 4.084
Authors: Johann Christian Virchow; Cezmi A Akdis; Josep Darba; Richard Dekhuijzen; Sylvia Hartl; Gisela Kobelt; Albert Roger; Steven Simoens; Mondher Toumi; Ben Woodhouse; Adam Plich; Saku Torvinen Journal: J Mark Access Health Policy Date: 2015-09-16