Garg Ria, Wang Tianru, Tadrous Mina, Antoniou Tony, Gomes Tara
ICES, Toronto, Ontario, Canada.
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
Pharmacoepidemiol Drug Saf. 2025 Apr;34(4):e70125. doi: 10.1002/pds.70125.
Several new respiratory inhalers have recently entered the market, including combination therapy products and generic alternatives. Therefore, we examined the cost and utilization of publicly dispensed respiratory inhalers in Ontario, Canada, and the impact of new market entrants on these trends.
We conducted a repeated cross-sectional study among provincial drug program beneficiaries dispensed a respiratory inhaler between January 1, 2003, and March 31, 2023. We estimated per-beneficiary spending on respiratory inhalers per quarter, defined as the cost (2022 Canadian dollars) of respiratory inhalers reimbursement divided by the number of beneficiaries dispensed a respiratory inhaler. Joinpoint regression models were used to characterize changes in the trend.
Between Q1 of 2003 and Q1 of 2023, public payer spending rose 160% ($26 206 322 to $68 054 816), while the number of beneficiaries dispensed a respiratory inhaler increased 92% (155 893 to 299 418). Reimbursement of ICS/LABA inhalers accounted for half the cost ($33 844 484 in Q1 of 2023). The trend for per-beneficiary spending was marked by six joinpoints, with periods of increasing and decreasing quarterly costs. Between 2003 and 2015, per-beneficiary spending increased, reaching $248/beneficiary in Q1 of 2015. In Q2 of 2015, the trend decreased for the first time and continued to decline until Q2 of 2018 ($206/beneficiary). The trend increased again after Q3 of 2018 and reached a plateau in Q3 of 2019 ($216/beneficiary).
Public formulary listing of combination therapy inhalers, namely LAMA/LABA in Q2 of 2015, coincided with a significant decline in per-beneficiary spending on respiratory inhalers.
近期有几种新型呼吸吸入器进入市场，包括联合治疗产品和仿制药。因此，我们研究了加拿大安大略省公共配给的呼吸吸入器的成本和使用情况，以及新进入市场的产品对这些趋势的影响。
我们对2003年1月1日至2023年3月31日期间获得呼吸吸入器配给的省级药物项目受益人进行了重复横断面研究。我们估计了每个受益人的每季度呼吸吸入器支出，定义为呼吸吸入器报销费用（2022年加拿大元）除以获得呼吸吸入器配给的受益人数。采用Joinpoint回归模型来描述趋势变化。
在2003年第一季度至2023年第一季度期间，公共支付方的支出增长了160%（从26206322加元增至68054816加元），而获得呼吸吸入器配给的受益人数增加了92%（从155893人增至299418人）。ICS/LABA吸入器的报销费用占成本的一半（2023年第一季度为33844484加元）。每个受益人的支出趋势有六个连接点，季度成本有增有减。2003年至2015年期间，每个受益人的支出增加，在2015年第一季度达到每人248加元。2015年第二季度，趋势首次下降，并持续下降至2018年第二季度（每人206加元）。2018年第三季度后趋势再次上升，并在2019年第三季度达到平稳（每人216加元）。
联合治疗吸入器（即2015年第二季度的LAMA/LABA）在公共处方目录中的列出，与每个受益人在呼吸吸入器上的支出显著下降相吻合。
