title: Exploratory economic evaluation of patients with COPD on a combination product versus individual components (ipratropium bromide and albuterol).
abstract: A population-based, retrospective claims analysis was undertaken to explore the economic profile of a nebulized ipratropium and albuterol combination product (DuoNeb(R) [DN], DEY, L.P., Napa, Calif). This analysis was performed to review expenditures and resource utilization of patients with chronic obstructive pulmonary disease (COPD) who were taking DN or generic ipratropium and albuterol (dual single agents [DSA]). Cohort selection criteria applied to the PharMetrics managed care claims database yielded 1531 patients: 468 DN and 1063 DSA. Total per-member-per-month (PMPM) expenditures were $1,840.36 for DN and $2,046.73 DSA (Delta$206.37; P=.22). Emergency department (ED) costs were $36.67 for DN and $52.84 for DSA (Delta$16.17; P=.03). Differences in regression analysis adjusted least squares means between DSA and DN were $264.62 (P=.083) for total expenditures and $20.81 (P=.03) for ED costs. Resource utilization reflected expenditure observations; ED visits were 0.93 for DN and 1.33 for DSA (P<.001). Inpatient expenditures (DN $874.97, DSA $1,105.80; Delta$230.83) represented the largest portion of total costs: 45% with DN and 54% with DSA. The DN cohort was associated with statistically fewer individuals who reported interruptions (0.78 vs 0.85; P=.003). The DN cohort did not appear to be more expensive than the DSA group, was associated with statistically lower ED expenditures, and included fewer individuals with therapy interruptions. Future analyses should include clinical data to better elucidate the full impact of DN on healthcare resources and compliance in the COPD population.
authors: Akita Biomedical Consulting, San Clemente, California 92672, USA. jyork1@cox.net
authors: John M
authors: JM
authors: York
authors: James
authors: J
authors: Smeeding
authors: Richard A
authors: RA
authors: Brook
authors: Fred
authors: F
authors: Hoehler
authors: Gerald L
authors: GL
authors: Klein
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000420:Albuterol / Q000191:economics* / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000191:economics* / Q000627:therapeutic use; D003365:Costs and Cost Analysis; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007345:Insurance Claim Review; D009241:Ipratropium / Q000191:economics* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy / Q000191:economics*; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D001993:Bronchodilator Agents; D004338:Drug Combinations; D009241:Ipratropium; D000420:Albuterol