Swetha R. Palli, MS1, Monica Frazer, PhD2, Mary DuCharme, MLIS2, Ami R. Buikema, MPH2, Amy J. Anderson, MS2, Jessica Franchino-Elder, PhD1

1Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, USA; 2Optum, Inc. Eden Prairie, MN, USA

Introduction

  • COPD has an onerous economic burden on patients and the healthcare system.
    • In 2010, the total economic burden of COPD in the US was estimated at $42.6 billion in direct healthcare expenditures, of which $11.3 billion were for hospital care.1
    • Each year COPD accounts for an average of 1.7 million emergency room (ER) visits, and 692,000 inpatient stays in the US.2, 3
  • The 2018 Global Initiative for Chronic Obstructive Lung Disease (GOLD)4 recommendations identify dual therapy with long-acting muscarinic antagonists (LAMAs) plus long-acting beta2 agonists (LABAs) for patients who have persistent symptoms and/or exacerbations on LAMA or LABA monotherapy (2018 GOLD guidelines were current during study design).
    • Escalation to triple therapy (TT; LAMA+LABA+inhaled corticosteroids [ICS]) is recommended in cases of further exacerbations and only after assessing the risks/benefits (e.g., pneumonia and other adverse effects linked to ICS use).
    • However, evidence reveals that TT is over-prescribed across all disease severities and inconsistent with GOLD recommendations, potentially impacting resource utilization.5, 6
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