Actionable Insights Newsletter

Translating research to power whole health

Issue 5    |    April 2023

Adherence to inhaled COPD medications results in significant clinical and economic benefits

Adherence to COPD regimen resulted in an estimated average saving of $141 per patient per month in total costs in addition to improved survival and lower risk of hospitalization.

Enterprise Analytics Core domain(s): Cost of care, quality of care, CarelonRx, value of integrated benefit

Summary

Background
In the US, COPD causes substantial illness, cost, and even death. While adherence to inhaled medications remains poor, there is little evidence assessing the causal relationship between the use of these medications and health outcomes in real-world settings. 

Objective and methods
Researchers at Carelon Research used longitudinal integrated medical and pharmacy claims data from Commercial and Medicare insured Anthem members with COPD to establish a causal relationship between COPD medication adherence and health outcomes. Medication adherence was measured based on proportion of days covered (PDC) by the regimen (PDC≥80% regarded as adherent). Researchers employed robust causal inference methods—marginal structural models, to account for factors that change over time, including adherence and patient risk factors.

Results
Of 86,307 patients with COPD, after accounting for differences in clinical and sociodemographic characteristics between adherent vs non-adherent groups, adherence to COPD regimen for at least 11 months resulted in:

• Significant reductions in risk of severe COPD exacerbation or all-cause mortality, all-cause and COPD-related inpatient admissions, and emergency room visits (Figure 1).
  
• Significant reductions in average all-cause total healthcare costs per patient per month. 
  
• The increased pharmacy costs (due to adherence) were offset by the decreased medical costs.
  
• Similar trends were observed for COPD-related costs.

Key takeaways