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Roflumilast: Who Is Using It and How It Affects Health Care Resource Utilization and Costs.
Manag Care. 2015 Aug; 24(8):40-8.MC

Abstract

OBJECTIVE

Compare baseline characteristics, health care resource utilization (HCRU), and associated costs of COPD patients treated with add-on roflumilast with those of other combination medications.

DESIGN

Retrospective cohort study.

METHODOLOGY

Patients aged 40 years with a diagnosis of chronic obstructive pulmonary disease (COPD) between March 1, 2011, and Nov. 30, 2012, were identified from the HealthCore Integrated Research Database and classified as roflumilast or nonroflumilast combination-therapy cohorts. Baseline characteristics were compared for all patients. HCRU and costs were compared between matched (M) roflumilast and nonroflumilast cohorts, using propensity score as a partial balancing score and then complementing the score with exact matching on specifically important variables. Generalized linear model and Poisson regression were used to estimate the adjusted differences in total costs and hospitalization rates, respectively, between the 2 matched cohorts.

RESULTS

A total of 695 roflumilast and 30,542 nonroflumilast combination therapy users were identified. At baseline, the roflumilast cohort had more complex COPD and a higher number of severe and moderate COPD exacerbations relative to the nonroflumilast cohort. After matching, the roflumilast (M) and nonroflumilast (M) cohorts (n = 328 in each) had similar mean age, gender distribution, and follow-up time. The roflumilast (M) cohort had significantly higher pharmacy-related, per-patient, per-month (PPPM) costs (P < .001) and similar total cost (P = .90). After adjusting for confounding variables, no difference was observed between the 2 cohorts in total costs (P = .86) and number of hospitalizations (P = .65).

CONCLUSION

Findings suggest that patients in the roflumilast cohort, relative to the nonroflumilast cohort, were more severely ill in the real-world setting. Despite higher pharmacy costs, the total cost for the roflumilast cohort was statistically similar to the nonroflumilast cohort. Future studies with longer follow-up are needed to evaluate the long-term economic impact of roflumilast use.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26399141

Citation

Jain, Rahul, et al. "Roflumilast: Who Is Using It and How It Affects Health Care Resource Utilization and Costs." Managed Care (Langhorne, Pa.), vol. 24, no. 8, 2015, pp. 40-8.
Jain R, Cai Q, Sun SX, et al. Roflumilast: Who Is Using It and How It Affects Health Care Resource Utilization and Costs. Manag Care. 2015;24(8):40-8.
Jain, R., Cai, Q., Sun, S. X., & Tan, H. (2015). Roflumilast: Who Is Using It and How It Affects Health Care Resource Utilization and Costs. Managed Care (Langhorne, Pa.), 24(8), 40-8.
Jain R, et al. Roflumilast: Who Is Using It and How It Affects Health Care Resource Utilization and Costs. Manag Care. 2015;24(8):40-8. PubMed PMID: 26399141.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Roflumilast: Who Is Using It and How It Affects Health Care Resource Utilization and Costs. AU - Jain,Rahul, AU - Cai,Qian, AU - Sun,Shawn X, AU - Tan,Hiangkiat, PY - 2015/9/25/entrez PY - 2015/9/25/pubmed PY - 2015/11/5/medline SP - 40 EP - 8 JF - Managed care (Langhorne, Pa.) JO - Manag Care VL - 24 IS - 8 N2 - OBJECTIVE: Compare baseline characteristics, health care resource utilization (HCRU), and associated costs of COPD patients treated with add-on roflumilast with those of other combination medications. DESIGN: Retrospective cohort study. METHODOLOGY: Patients aged 40 years with a diagnosis of chronic obstructive pulmonary disease (COPD) between March 1, 2011, and Nov. 30, 2012, were identified from the HealthCore Integrated Research Database and classified as roflumilast or nonroflumilast combination-therapy cohorts. Baseline characteristics were compared for all patients. HCRU and costs were compared between matched (M) roflumilast and nonroflumilast cohorts, using propensity score as a partial balancing score and then complementing the score with exact matching on specifically important variables. Generalized linear model and Poisson regression were used to estimate the adjusted differences in total costs and hospitalization rates, respectively, between the 2 matched cohorts. RESULTS: A total of 695 roflumilast and 30,542 nonroflumilast combination therapy users were identified. At baseline, the roflumilast cohort had more complex COPD and a higher number of severe and moderate COPD exacerbations relative to the nonroflumilast cohort. After matching, the roflumilast (M) and nonroflumilast (M) cohorts (n = 328 in each) had similar mean age, gender distribution, and follow-up time. The roflumilast (M) cohort had significantly higher pharmacy-related, per-patient, per-month (PPPM) costs (P < .001) and similar total cost (P = .90). After adjusting for confounding variables, no difference was observed between the 2 cohorts in total costs (P = .86) and number of hospitalizations (P = .65). CONCLUSION: Findings suggest that patients in the roflumilast cohort, relative to the nonroflumilast cohort, were more severely ill in the real-world setting. Despite higher pharmacy costs, the total cost for the roflumilast cohort was statistically similar to the nonroflumilast cohort. Future studies with longer follow-up are needed to evaluate the long-term economic impact of roflumilast use. SN - 1062-3388 UR - https://www.unboundmedicine.com/medline/citation/26399141/Roflumilast:_Who_Is_Using_It_and_How_It_Affects_Health_Care_Resource_Utilization_and_Costs_ L2 - http://www.managedcaremag.com/linkout/2015/8/40 DB - PRIME DP - Unbound Medicine ER -