title: COPD-related healthcare utilization and costs after discharge from a hospitalization or emergency department visit on a regimen of fluticasone propionate-salmeterol combination versus other maintenance therapies.
abstract: OBJECTIVE
  To quantify healthcare use and costs associated with chronic obstructive pulmonary disease (COPD) among patients discharged from a COPD-related hospitalization or emergency department (ED) visit on a regimen of fluticasone propionate-salmeterol combination versus other inhaled maintenance therapies.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Managed care enrollees with an index hospitalization (with a primary or secondary [ie, in the second position] diagnosis of COPD) or ED visit (with a primary diagnosis of COPD) were identified for placement into study cohorts during a 60-day period following the index date. Time to COPD-related events and healthcare costs were compared during up to 1 year of follow-up between the 2 cohorts.
  
  
  RESULTS
  The sample comprised 5677 patients (1291 in the fluticasone propionate-salmeterol cohort and 4386 in the other maintenance therapies cohort). The adjusted rate of COPD-related hospitalizations or ED visits was 35% lower in the fluticasone propionate-salmeterol cohort (P <.05). Adjusted COPD-related total (medical plus pharmacy) costs were lower in the fluticasone propionate-salmeterol cohort ($240 vs $279 per patient per month, P <.05), mostly because of lower medical costs ($113 vs $160 per patient per month, P <.05). Pharmacy costs did not differ between fluticasone propionate-salmeterol and other maintenance therapies. Results were similar in the subset of patients 65 years or older.
  
  
  CONCLUSIONS
  Initiation of fluticasone propionate-salmeterol after discharge from a COPD-related hospitalization or ED visit significantly reduced the risk of a recurrent event during the ensuing months and decreased COPD-related medical costs, without an increase in COPD-related pharmacy costs, in a real-world setting.
authors.affiliation: GlaxoSmith-Kline, Research Triangle Park, Durham, NC 27709, USA. anand.a.dalal@gsk.com
authors.forename: Anand A
authors.initials: AA
authors.lastname: Dalal
authors.forename: Manan
authors.initials: M
authors.lastname: Shah
authors.forename: Anna O
authors.initials: AO
authors.lastname: D'Souza
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Mapel
mesh_terms: D000368:Aged; D000420:Albuterol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000730:Androstadienes / Q000627:therapeutic use*; D015331:Cohort Studies; D016208:Databases, Factual; D004338:Drug Combinations; D016527:Drug Costs / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital; D005260:Female; D000068297:Fluticasone-Salmeterol Drug Combination; D005938:Glucocorticoids / Q000627:therapeutic use*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006296:Health Services / Q000706:statistics & numerical data*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D012189:Retrospective Studies; D018570:Risk Assessment
chemical_list: D000730:Androstadienes; D004338:Drug Combinations; D000068297:Fluticasone-Salmeterol Drug Combination; D005938:Glucocorticoids; D000420:Albuterol