Patients who used fixed-dose combinations of long-acting beta-agonists and inhaled corticosteroids had a greater risk for asthma-related health care utilization compared with inhaled corticosteroids alone, according to research presented at the International Society for Pharmacoeconomics and Outcomes Research annual meeting in Montreal.
Christie Teigland, PhD, director of statistical research for Inovalon, and colleagues studied 29,670 patients (mean age, 38.4 years; 38% male) from a national claims database across all payer types including commercial, Medicare and Medicaid from 2006 to 2012. Patients were continuously enrolled in a commercial heath plan with medical and pharmacy coverage for 12 months before and after treatment initiation. New prescription fills for fixed-dose long-acting beta-agonists (LABA) plus inhaled corticosteroids (ICS) or ICS alone after asthma diagnosis were measured during the study.
Because treatment initiations were not randomly assigned, a propensity score matching technique was used, with 50% of the study population in the LABA+ICS cohort (n=14,835) and 50% in the ICS alone cohort. Patients were followed up to 12 months.
“Compared with ICS alone, fixed-dose combination of LABA and ICS cohort was significantly associated with higher risk of any asthma-related utilization event and higher risk of asthma-related emergency department visits,” the researchers reported.
“This study adds further evidence to the ongoing data over whether the high use and added cost of fixed-dose LABA and ICS combination therapy is consistent with the triple aim of providing better care, better health and better value to the health care system.”
Disclosure: The internal study was funded by Inovalon. The researchers report no relevant financial disclosures.
For more information:
Parente A. #PRS5. Presented at: International Society of Pharmacoeconomics and Outcomes Research Annual International Meeting; May 31-June 4, 2014; Montreal.