Thomson Reuters, Cambridge, MA, USA.
J Med Econ. 2011;14(2):147-58. doi: 10.3111/13696998.2011.552582. Epub 2011 Feb 2.
To evaluate chronic obstructive pulmonary disease (COPD)-related expenditure and hospitalisation in COPD patients treated with tiotropium versus alternative long-acting bronchodilators (LABDs).
Data were from the Thomson Reuters MarketScan Research Databases. COPD patients ≥ 35 years with at least one LABD claim between July 1, 2004 and June 30, 2006 were classified into five cohorts based on index LABD: monotherapy with tiotropium, salmeterol/fluticasone propionate, formoterol fumarate, or salmeterol or combination therapy. Demographic and clinical characteristics were evaluated for a 6-month pre-period and COPD-related utilisation and total costs were evaluated for a 12-month follow-up period. LABD relationship to COPD-related costs and hospitalisations were estimated by multivariate generalised linear modelling (GLM) and multivariate logistic regression, respectively.
Of 52,274 patients, 53% (n = 27,457) were male, 71% (n = 37,271) were ≥ 65 years, and three LABD cohorts accounted for over 90% of the sample [53% (n = 27,654) salmeterol/fluticasone propionate, 23% (n = 11,762) tiotropium, and 15% (n = 7755) combination therapy]. Patients treated with salmeterol/fluticasone propionate (p < 0.001), formoterol fumarate (p = 0.032), salmeterol (p = 0.004), or with combination therapy (p < 0.001) had higher COPD-related costs and a greater risk of inpatient admission (p < 0.01 for all) versus tiotropium.
These data are based on administrative claims and as such do not include clinical information or information on risk factors, like smoking status, that are relevant to this population.
Patients treated with tiotropim had lower COPD-related expenditures and risk of hospitalisation than patients treated with other LABDs.
评估噻托溴铵与其他长效支气管扩张剂（LABD）治疗慢性阻塞性肺疾病（COPD）患者的 COPD 相关支出和住院情况。
数据来自汤森路透 MarketScan 研究数据库。2004 年 7 月 1 日至 2006 年 6 月 30 日期间，至少有一次 LABD 索赔的年龄≥35 岁的 COPD 患者根据索引 LABD 分为五组：噻托溴铵单药治疗、沙美特罗/氟替卡松丙酸酯、福莫特罗富马酸盐、沙美特罗或联合治疗。评估了 6 个月的预治疗期的人口统计学和临床特征，并评估了 12 个月的随访期的 COPD 相关利用和总费用。通过多元广义线性模型（GLM）和多元逻辑回归分别估计 LABD 与 COPD 相关成本和住院的关系。
在 52274 名患者中，53%（n=27457）为男性，71%（n=37271）≥65 岁，三个 LABD 队列占样本的 90%以上[53%（n=27654）沙美特罗/氟替卡松丙酸酯、23%（n=11762）噻托溴铵和 15%（n=7755）联合治疗]。与噻托溴铵相比，接受沙美特罗/氟替卡松丙酸酯（p<0.001）、福莫特罗富马酸盐（p=0.032）、沙美特罗（p=0.004）或联合治疗（p<0.001）的患者的 COPD 相关费用更高，住院风险更高（p<0.01 均为）。
这些数据基于行政索赔，因此不包括与该人群相关的临床信息或风险因素信息，如吸烟状况。
与其他 LABD 治疗相比，接受噻托溴铵治疗的患者的 COPD 相关支出和住院风险较低。
