![]() ![]() Patients in the DT cohort had lower rates of switching ( p<0.001) and augmentation ( p<0.001), and higher rates of non-persistence ( p<0.001) versus the MT cohort. This occurred despite lower mean COPD-related pharmacy fills PPPM in the DT versus MT cohorts (1.41 versus 1.51, respectively p=0.038). Patients in the DT versus MT cohort had lower rates of exacerbations leading to hospitalization (incidence rate ratio 0.7886 p=0.019), lower mean COPD-related pharmacy costs per patient per month (PPPM) ($300 versus $379, respectively p<0.001) and total costs PPPM ($990 versus $1203, respectively p=0.003). Patients were followed for approximately 1 year. Results: Following propensity score matching (PSM), 1286 patients remained in each cohort for analysis. Cohorts were propensity score matched 1:1 using baseline measures (e.g., exacerbations, hospitalizations) as proxies for COPD severity to create balanced cohorts. ![]() Patients diagnosed with cystic fibrosis, idiopathic pulmonary fibrosis, or asthma were excluded. Methods: COPD patients aged ≥ 40 years initiating monotherapy (MT) with either a long-acting muscarinic antagonist (LAMA) or long-acting beta2-agonist (LABA) or dual therapy (DT) with a LAMA/LABA fixed dose combination (FDC) between Januand Decemwere identified from a large U.S. Real world evidence for the benefits of combination therapy compared to monotherapy is lacking. (Breo ® Ellipta ® 100 mcg/25 mcg, Advair ® Diskus ® 250 mcg/50 mcg, 500 mcg/50 mcg)įor specific updated COPD drug coverage as of July 7, 2020, refer to the links beside the limited coverage products, which will take you to the Special Authority criteria.Introduction: Patients with chronic obstructive pulmonary disease (COPD) increasingly receive combination bronchodilator therapies. (Duaklir ® Genuair ®, Ultibro ® Breezhaler ®, Inspiolto ® Respimat ®, Anoro ® Ellipta ®) ![]() (Onbrez ® Breezhaler ®, Serevent ® Diskus ®) (Tudorza ® Genuair ®, Seebri ® Breezhaler ®, Spiriva ® Handihaler ®) ![]() (Incruse ® Ellipta ®, Spiriva ® Respimat ®) (Ventolin ®, Airomir™, Bricanyl ® Turbuhaler ®) History of ≥ 1 severe exacerbation defined as requiring a hospital admission or emergency department visit in the previous 12 months.ĤHistory of exacerbations is defined as follows:Ĭurrent coverage will be maintained for patients currently covered for COPD inhalers through PharmaCare, though some will have the option to switch.History of ≥ 2 moderate exacerbations defined as requiring a prescribed antibiotic and/or using systemic glucocorticoids in the previous 12 months or.Very severe COPD is defined as FEV1 Severe COPD is defined as 30% Moderate COPD is defined as 50% List Trelegy Ellipta, the new triple therapy fixed-dose combination (i.e., ICS-LABA-LAMA), as a limited coverage benefit for moderate-to-very-severe patients with COPD diagnosed by spirometry, history of exacerbations 4, with a 6-month trial of either a LAMA-LABA combination or an ICS-LABA combinationġThe spirometry requirement for the diagnosis of moderate-to-very-severe COPD requires a post-bronchodilator fixed ratio of FEV1/forced vital capacity (FVC) Modify criteria for inhaled corticosteroids (ICS)-LABA combination inhalers to include diagnosis for moderate-to-very-severe COPD by spirometry, history of exacerbations 3, and a 6-month trial of either a LAMA or a LABA.Increase access to LAMA-LABA combination therapies for moderate to very severe 2 patients with COPD by expanding the current forced expiratory volume in 1 second (FEV 1) threshold requirement from Modify criteria for long-acting beta 2 agonists (LABA) to include diagnosis 1 of COPD by spirometry and contraindications or intolerance to a LAMA.Continue coverage for other LAMAs (Tudorza ® Genuair ®, Spiriva ® Handihaler ®, Seebri ® Breezhaler ®) as limited coverage benefits with changes in criteria: failure on a minimum one-month trial of each of the regular benefit LAMA products.Improve access to long-acting muscarinic antagonists (LAMA) by moving tiotropium (Spiriva ® Respimat ®) and umeclidinium (Incruse ® Ellipta ®) from limited coverage benefits to regular benefit coverage. ![]()
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