Xiaoli Niu, Divino, Victoria, Sharma, Sanjay, Dekoven, Mitch, Anupindi, Vamshi Ruthwik, and Dembek, Carole
Aims: This study compared medication use, healthcare resource utilization (HRU), and exacerbations among individuals with chronic obstructive pulmonary disease (COPD) who initiated glycopyrrolate/eFlow Closed System nebulizer 25 mcg/mL glycopyrrolate (hereafter GLY) in a real-world setting before and after treatment initiation. Materials and methods: Retrospective claims and hospital charge master data were used to identify individuals ≥ 40 years of age diagnosed with COPD who initiated GLY between 1 April 2018 and 28 February 2019 (first prescription claim-index date). Patients were excluded if they had ≥1 asthma diagnosis in the 6-month pre-index period. The proportion of patients with COPD-related medications, other outpatient HRU, hospitalizations, and exacerbations were compared between the 6-month preindex and 6-month follow-up periods. Among patients utilizing the service, per-person utilization rates were compared between the two periods. Results: Among patients initiating GLY (n=767), the mean age was 71.4 years, 56.1% were female, and the mean Charlson Comorbidity Index score was 2.0. The mean number of GLY claims per person was 3.8 during the follow-up period. Compared to the pre-index period, a lower proportion of patients had claims for COPD medications including oral corticosteroids (62.1% vs. 69.1%, p=.0001) and fixeddose SAMA/SABA (26.1% vs. 33.0%, p<.0001) and a higher proportion of patients had claims for LABA (29.7% vs. 22.6%, p<.0001) during the follow-up period. Fewer patients had ≥1 COPD-related physician office visit (42.4% vs. 49.8%, p<.0001), radiology test (40.7% vs. 46.5%, p=.005), or moderate exacerbation (48.0% vs. 53.2%, p=.01) after initiating GLY. Among patients with linkage to inpatient data (n=316), fewer were hospitalized (7.9% vs. 13.0%, p=.037) and hospital length of stay was shorter (1.9 vs. 3.6 days, p=.017) after initiating GLY/eFlow. Conclusions: Among patients initiating GLY in a real-world setting, COPD medications, hospitalizations, other HRU, and exacerbations decreased after treatment initiation compared with the 6-month pre-index period. [ABSTRACT FROM AUTHOR]