title: Respiratory-related medical expenditure and inpatient utilisation among COPD patients receiving long-acting bronchodilator therapy.
abstract: OBJECTIVE
  To evaluate chronic obstructive pulmonary disease (COPD)-related expenditure and hospitalisation in COPD patients treated with tiotropium versus alternative long-acting bronchodilators (LABDs).
  
  
  METHODS
  Data were from the Thomson Reuters MarketScan Research Databases. COPD patients ≥ 35 years with at least one LABD claim between July 1, 2004 and June 30, 2006 were classified into five cohorts based on index LABD: monotherapy with tiotropium, salmeterol/fluticasone propionate, formoterol fumarate, or salmeterol or combination therapy. Demographic and clinical characteristics were evaluated for a 6-month pre-period and COPD-related utilisation and total costs were evaluated for a 12-month follow-up period. LABD relationship to COPD-related costs and hospitalisations were estimated by multivariate generalised linear modelling (GLM) and multivariate logistic regression, respectively.
  
  
  RESULTS
  Of 52,274 patients, 53% (n = 27,457) were male, 71% (n = 37,271) were ≥ 65 years, and three LABD cohorts accounted for over 90% of the sample [53% (n = 27,654) salmeterol/fluticasone propionate, 23% (n = 11,762) tiotropium, and 15% (n = 7755) combination therapy]. Patients treated with salmeterol/fluticasone propionate (p < 0.001), formoterol fumarate (p = 0.032), salmeterol (p = 0.004), or with combination therapy (p < 0.001) had higher COPD-related costs and a greater risk of inpatient admission (p < 0.01 for all) versus tiotropium.
  
  
  CONCLUSIONS
  These data are based on administrative claims and as such do not include clinical information or information on risk factors, like smoking status, that are relevant to this population.
  
  
  CONCLUSIONS
  Patients treated with tiotropim had lower COPD-related expenditures and risk of hospitalisation than patients treated with other LABDs.
authors.affiliation: Thomson Reuters, Cambridge, MA, USA.
authors.forename: Zhun
authors.initials: Z
authors.lastname: Cao
authors.forename: Kelly H
authors.initials: KH
authors.lastname: Zou
authors.forename: Christine L
authors.initials: CL
authors.lastname: Baker
authors.forename: Jun
authors.initials: J
authors.lastname: Su
authors.forename: Ryne
authors.initials: R
authors.lastname: Paulose-Ram
authors.forename: Emily
authors.initials: E
authors.lastname: Durden
authors.forename: Nianwen
authors.initials: N
authors.lastname: Shi
authors.forename: Hemal
authors.initials: H
authors.lastname: Shah
mesh_terms: D000328:Adult; D000368:Aged; D001993:Bronchodilator Agents / Q000191:economics* / Q000493:pharmacokinetics / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data*; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy / Q000191:economics*; D012189:Retrospective Studies; D012602:Scopolamine Derivatives / Q000191:economics* / Q000493:pharmacokinetics / Q000627:therapeutic use; D013997:Time Factors; D000069447:Tiotropium Bromide; D014481:United States
chemical_list: D001993:Bronchodilator Agents; D012602:Scopolamine Derivatives; D000069447:Tiotropium Bromide