Open Triple Therapy for Chronic Obstructive Pulmonary Disease: Patterns of Prescription, Exacerbations and Healthcare Costs From a Large Italian Claims Database

Study type

• Study topic:
  Disease /health condition

  Human medicinal product
• Study type:
  Non-interventional study
• Scope of the study:
  Drug utilisation

  Healthcare resource utilisation
• Data collection methods:
  Secondary use of data

Non-interventional study

• Non-interventional study design:
  Cohort

Study drug and medical condition

• Anatomical Therapeutic Chemical (ATC) code:
  (R03) DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

  DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES
• Medical condition to be studied:
  Chronic obstructive pulmonary disease

Population studied

• Short description of the study population:
  Italian population aged ≥45
• Age groups:
  • Adults (18 to < 46 years)
  • Adults (46 to < 65 years)
  • Elderly (≥ 65 years)

    • Adults (65 to < 75 years)
    • Adults (75 to < 85 years)
    • Adults (85 years and over)

Study design details

• Study design:
  Patients aged ≥45 supplied with at least 2 boxes of R03 drugs labelled for COPD during 2014 were identified. Subjects with asthma were excluded. Index date=the former date of filled prescription of ICS/LABA or of LAMA. One year before and one year after the index date were analysed.
• Main study objective:
  To describe the burden of patients aged 45 and older potentially eligible to the open TT in 2014, according to the authorized therapeutic indications, in terms of specific drugs supply, spirometry test performances, exacerbations occurrences, and of direct healthcare costs reimbursed by the SSN.
• Setting:
  Inpatient and oupatient
• Summary results:
  In 2014, 10,352 patients (mean age 74 ± 9; males 66.0%) with COPD and treated with open TT were identified (prevalence 160.6 per 100,000 inhabitants aged ≥45). During the previous year, the 44.0% of this cohort was already treated with open TT, 7.0% did not received any drugs for obstructive airway diseases, 11.1% needed home oxygen therapy, and 28.7% experienced at least an exacerbation. In the follow-up year, the 37.5% of the cohort was found persistent to the open TT, 17.0% needed oxygen therapy, and the 30.9% underwent an exacerbation. Spirometry was performed on 45.7% of patients in the two previous years, while on 33.3% in the subsequent year. In the follow-up, on average, every patient of the cohort costed to the NHS €5,295: 48.2% for hospitalizations, 41.2% for drugs and 10.6% for outpatient services.