Trial Outcomes & Findings for A Study Using US Medical and Pharmacy Claim Records to Compare the Resource Use, Cost, and Outcomes of People With COPD Who Take Either Tiotropium + Olodaterol or Fluticasone + Umeclidinium + Vilanterol (NCT NCT05127304)

NCT ID: NCT05127304

Last Updated: 2023-11-13

Results Overview

All-cause health care resource utilization. Annualized population averages of visits for each of the following categories is reported: * Ambulatory visits * Office visits * Outpatient visits * Emergency room visits * Inpatient visits * Other medical visits (included services like independent laboratory, home health, durable medical equipment, etc.) Annualized population averages of visits were calculated as: (\[sum of all visits for all individuals during the follow-up period\] / \[sum of follow-up on-treatment time in years (365 days) for all individuals\]).

Recruitment status

COMPLETED

Target enrollment

11316 participants

Primary outcome timeframe

Follow-up period (started on the day after the index date, with a minimum of 30-days duration (index date + 1 through index date+30) up to a maximum of 12 months duration (index date + 1 through index date +365).

Results posted on

2023-11-13

Participant Flow

This was a non-interventional study using existing data from commercial and Medicare Advantage Part D (MAPD) beneficiaries, using administrative claims data for the period of 01 June 2015 through 30 November 2019.

Only subjects that met all inclusion and none of the exclusion criteria were included.

Participant milestones

Participant milestones
Measure
Tiotropium Bromide/Olodaterol (TIO/OLO)
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with TIO/OLO initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the TIO/OLO pharmacy claim that started the ≥30 consecutive days with the medication.
Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI)
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with FF/UMEC/VI initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the FF/UMEC/VI pharmacy claim that started the ≥30 consecutive days with the medication.
Overall Study
STARTED
5658
5658
Overall Study
COMPLETED
5658
5658
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

A Study Using US Medical and Pharmacy Claim Records to Compare the Resource Use, Cost, and Outcomes of People With COPD Who Take Either Tiotropium + Olodaterol or Fluticasone + Umeclidinium + Vilanterol

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Tiotropium Bromide/Olodaterol (TIO/OLO)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with TIO/OLO initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the TIO/OLO pharmacy claim that started the ≥30 consecutive days with the medication.
Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with FF/UMEC/VI initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the FF/UMEC/VI pharmacy claim that started the ≥30 consecutive days with the medication.
Total
n=11316 Participants
Total of all reporting groups
Age, Continuous
71.69 Years
STANDARD_DEVIATION 8.69 • n=99 Participants
71.75 Years
STANDARD_DEVIATION 8.61 • n=107 Participants
71.72 Years
STANDARD_DEVIATION 8.65 • n=206 Participants
Sex: Female, Male
Female
2846 Participants
n=99 Participants
2866 Participants
n=107 Participants
5712 Participants
n=206 Participants
Sex: Female, Male
Male
2812 Participants
n=99 Participants
2792 Participants
n=107 Participants
5604 Participants
n=206 Participants
Race/Ethnicity, Customized
Hispanic
311 Participants
n=99 Participants
281 Participants
n=107 Participants
592 Participants
n=206 Participants
Race/Ethnicity, Customized
Non- Hispanic Black
731 Participants
n=99 Participants
740 Participants
n=107 Participants
1471 Participants
n=206 Participants
Race/Ethnicity, Customized
Non- Hispanic White
4015 Participants
n=99 Participants
3815 Participants
n=107 Participants
7830 Participants
n=206 Participants
Race/Ethnicity, Customized
Non- Hispanic Asian
78 Participants
n=99 Participants
62 Participants
n=107 Participants
140 Participants
n=206 Participants
Race/Ethnicity, Customized
Other/unknown
523 Participants
n=99 Participants
760 Participants
n=107 Participants
1283 Participants
n=206 Participants

PRIMARY outcome

Timeframe: Follow-up period (started on the day after the index date, with a minimum of 30-days duration (index date + 1 through index date+30) up to a maximum of 12 months duration (index date + 1 through index date +365).

Population: Matched Overall Population: Stratified propensity score matching (PSM), using an exact match on some variables and a propensity score match on the others, was used to control for possible confounding of the association between the outcomes and treatment with TIO/OLO or FF/UMEC/VI. Patients were matched in a 1:1 ratio of TIO/OLO to FF/UMEC/VI.

All-cause health care resource utilization. Annualized population averages of visits for each of the following categories is reported: * Ambulatory visits * Office visits * Outpatient visits * Emergency room visits * Inpatient visits * Other medical visits (included services like independent laboratory, home health, durable medical equipment, etc.) Annualized population averages of visits were calculated as: (\[sum of all visits for all individuals during the follow-up period\] / \[sum of follow-up on-treatment time in years (365 days) for all individuals\]).

Outcome measures

Outcome measures
Measure
Tiotropium Bromide/Olodaterol (TIO/OLO)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with TIO/OLO initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the TIO/OLO pharmacy claim that started the ≥30 consecutive days with the medication.
Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with FF/UMEC/VI initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the FF/UMEC/VI pharmacy claim that started the ≥30 consecutive days with the medication.
All-cause Health Care Resource Utilization
Office visits
17.80 visits/year
Interval 17.25 to 18.35
17.57 visits/year
Interval 17.08 to 18.06
All-cause Health Care Resource Utilization
Ambulatory visits
32.54 visits/year
Interval 31.44 to 33.64
32.91 visits/year
Interval 31.84 to 33.97
All-cause Health Care Resource Utilization
Outpatient visits
14.82 visits/year
Interval 13.95 to 15.69
15.42 visits/year
Interval 14.55 to 16.28
All-cause Health Care Resource Utilization
Emergency room visits
1.26 visits/year
Interval 1.17 to 1.35
1.39 visits/year
Interval 1.29 to 1.5
All-cause Health Care Resource Utilization
Inpatient visits
0.45 visits/year
Interval 0.41 to 0.48
0.48 visits/year
Interval 0.44 to 0.52
All-cause Health Care Resource Utilization
Other medical visits
10.09 visits/year
Interval 9.69 to 10.49
10.48 visits/year
Interval 10.07 to 10.89

PRIMARY outcome

Timeframe: Follow-up period (started on the day after the index date, with a minimum of 30-days duration (index date + 1 through index date+30) up to a maximum of 12 months duration (index date + 1 through index date +365).

Population: Matched Overall Population: Stratified propensity score matching (PSM), using an exact match on some variables and a propensity score match on the others, was used to control for possible confounding of the association between the outcomes and treatment with TIO/OLO or FF/UMEC/VI. Patients were matched in a 1:1 ratio of TIO/OLO to FF/UMEC/VI.

All-cause health care resource utilization: Inpatient days. Annualized population averages of inpatient days is reported. Annualized population averages of inpatient days were calculated as: (\[sum of all inpatient days for all individuals during the follow-up period\] / \[sum of follow-up on-treatment time in years (365 days) for all individuals\]).

Outcome measures

Outcome measures
Measure
Tiotropium Bromide/Olodaterol (TIO/OLO)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with TIO/OLO initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the TIO/OLO pharmacy claim that started the ≥30 consecutive days with the medication.
Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with FF/UMEC/VI initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the FF/UMEC/VI pharmacy claim that started the ≥30 consecutive days with the medication.
All-cause Health Care Resource Utilization: Inpatient Days
4.30 inpatient days/year
Interval 3.8 to 4.79
4.68 inpatient days/year
Interval 4.12 to 5.24

PRIMARY outcome

Timeframe: Follow-up period (started on the day after the index date, with a minimum of 30-days duration (index date + 1 through index date+30) up to a maximum of 12 months duration (index date + 1 through index date +365).

Population: Matched Overall Population: Stratified propensity score matching (PSM), using an exact match on some variables and a propensity score match on the others, was used to control for possible confounding of the association between the outcomes and treatment with TIO/OLO or FF/UMEC/VI. Patients were matched in a 1:1 ratio of TIO/OLO to FF/UMEC/VI.

All-cause health care resource utilization: Pharmacy fills. Annualized population averages for pharmacy fills is reported. Annualized population averages of pharmacy fills were calculated as:(\[sum of all pharmacy fills for all individuals during the follow-up period\] / \[sum of follow-up on-treatment time in years (365 days) for all individuals\]).

Outcome measures

Outcome measures
Measure
Tiotropium Bromide/Olodaterol (TIO/OLO)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with TIO/OLO initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the TIO/OLO pharmacy claim that started the ≥30 consecutive days with the medication.
Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with FF/UMEC/VI initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the FF/UMEC/VI pharmacy claim that started the ≥30 consecutive days with the medication.
All-cause Health Care Resource Utilization: Pharmacy Fills
59.39 pharmacy fills/year
Interval 58.05 to 60.73
57.13 pharmacy fills/year
Interval 55.75 to 58.52

PRIMARY outcome

Timeframe: Follow-up period (started on the day after the index date, with a minimum of 30-days duration (index date + 1 through index date+30) up to a maximum of 12 months duration (index date + 1 through index date +365).

Population: Matched Overall Population: Stratified propensity score matching (PSM), using an exact match on some variables and a propensity score match on the others, was used to control for possible confounding of the association between the outcomes and treatment with TIO/OLO or FF/UMEC/VI. Patients were matched in a 1:1 ratio of TIO/OLO to FF/UMEC/VI.

Chronic Obstructive Pulmonary Disease (COPD)-related (medical claims with a diagnosis for COPD in any position and pharmacy claims for a COPD-related treatment, including COPD-guideline recommended antibiotics) health care resource utilization. Population annualized averages of visits for each of the following categories is reported: * Ambulatory visits * Office visits * Outpatient visits * Emergency room visits * Inpatient visits * Other medical visits (included services like independent laboratory, home health, durable medical equipment, etc.). Annualized population averages of visits were calculated as: (\[sum of all visits for all individuals during the follow-up period\] / \[sum of follow-up on-treatment time in years (365 days) for all individuals\]).

Outcome measures

Outcome measures
Measure
Tiotropium Bromide/Olodaterol (TIO/OLO)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with TIO/OLO initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the TIO/OLO pharmacy claim that started the ≥30 consecutive days with the medication.
Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with FF/UMEC/VI initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the FF/UMEC/VI pharmacy claim that started the ≥30 consecutive days with the medication.
COPD-related Health Care Resource Utilization
Emergency room visits
0.65 visits/year
Interval 0.59 to 0.71
0.65 visits/year
Interval 0.59 to 0.71
COPD-related Health Care Resource Utilization
Ambulatory visits
8.77 visits/year
Interval 8.3 to 9.23
9.56 visits/year
Interval 9.05 to 10.08
COPD-related Health Care Resource Utilization
Office visits
3.92 visits/year
Interval 3.8 to 4.05
4.07 visits/year
Interval 3.93 to 4.2
COPD-related Health Care Resource Utilization
Outpatient visits
4.85 visits/year
Interval 4.42 to 5.28
5.51 visits/year
Interval 5.03 to 5.98
COPD-related Health Care Resource Utilization
Inpatient visits
0.39 visits/year
Interval 0.36 to 0.42
0.44 visits/year
Interval 0.41 to 0.48
COPD-related Health Care Resource Utilization
Other medical visits
4.28 visits/year
Interval 4.04 to 4.53
4.87 visits/year
Interval 4.61 to 5.13

PRIMARY outcome

Timeframe: Follow-up period (started on the day after the index date, with a minimum of 30-days duration (index date + 1 through index date+30) up to a maximum of 12 months duration (index date + 1 through index date +365).

Population: Matched Overall Population: Stratified propensity score matching (PSM), using an exact match on some variables and a propensity score match on the others, was used to control for possible confounding of the association between the outcomes and treatment with TIO/OLO or FF/UMEC/VI. Patients were matched in a 1:1 ratio of TIO/OLO to FF/UMEC/VI.

Chronic Obstructive Pulmonary Disease (COPD)-related (medical claims with a diagnosis for COPD in any position and pharmacy claims for a COPD-related treatment, including COPD-guideline recommended antibiotics) health care resource utilization: Inpatient days. Population annualized averages of inpatient days is reported. Annualized population averages of inpatient days were calculated as: (\[sum of all inpatient days for all individuals during the follow-up period\] / \[sum of follow-up on-treatment time in years (365 days) for all individuals\]).

Outcome measures

Outcome measures
Measure
Tiotropium Bromide/Olodaterol (TIO/OLO)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with TIO/OLO initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the TIO/OLO pharmacy claim that started the ≥30 consecutive days with the medication.
Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with FF/UMEC/VI initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the FF/UMEC/VI pharmacy claim that started the ≥30 consecutive days with the medication.
COPD-related Health Care Resource Utilization: Inpatient Days
3.91 inpatient days/year
Interval 3.43 to 4.38
4.42 inpatient days/year
Interval 3.87 to 4.97

PRIMARY outcome

Timeframe: Follow-up period (started on the day after the index date, with a minimum of 30-days duration (index date + 1 through index date+30) up to a maximum of 12 months duration (index date + 1 through index date +365).

Population: Matched Overall Population: Stratified propensity score matching (PSM), using an exact match on some variables and a propensity score match on the others, was used to control for possible confounding of the association between the outcomes and treatment with TIO/OLO or FF/UMEC/VI. Patients were matched in a 1:1 ratio of TIO/OLO to FF/UMEC/VI.

Chronic Obstructive Pulmonary Disease (COPD)-related (medical claims with a diagnosis for COPD in any position and pharmacy claims for a COPD-related treatment, including COPD-guideline recommended antibiotics) health care resource utilization. Population annualized averages for pharmacy fills is reported. Annualized population averages of pharmacy fills were calculated as: (\[sum of all pharmacy fills for all individuals during the follow-up period\] / \[sum of follow-up on-treatment time in years (365 days) for all individuals\]).

Outcome measures

Outcome measures
Measure
Tiotropium Bromide/Olodaterol (TIO/OLO)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with TIO/OLO initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the TIO/OLO pharmacy claim that started the ≥30 consecutive days with the medication.
Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with FF/UMEC/VI initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the FF/UMEC/VI pharmacy claim that started the ≥30 consecutive days with the medication.
COPD-related Health Care Resource Utilization: Pharmacy Fills
15.48 pharmacy fills/year
Interval 15.2 to 15.77
15.08 pharmacy fills/year
Interval 14.82 to 15.35

PRIMARY outcome

Timeframe: Follow-up period (started on the day after the index date, with a minimum of 30-days duration (index date + 1 through index date+30) up to a maximum of 12 months duration (index date + 1 through index date +365).

Population: Matched Overall Population: Stratified propensity score matching (PSM), using an exact match on some variables and a propensity score match on the others, was used to control for possible confounding of the association between the outcomes and treatment with TIO/OLO or FF/UMEC/VI. Patients were matched in a 1:1 ratio of TIO/OLO to FF/UMEC/VI.

Chronic Obstructive Pulmonary Disease (COPD) and/or pneumonia-related health care resource utilization (medical claims with a diagnosis for COPD, pneumonia, or acute bronchitis/bronchiolitis in any position and pharmacy claims for a COPD-related treatment, including COPD-guideline recommended antibiotics). Population annualized averages of visits in each of the following categories is reported: * Ambulatory visits * Office visits * Outpatient visits * Emergency room visits * Inpatient visits * Other medical visits (independent laboratory, home health, durable medical equipment, etc.) Population annualized averages of visits were calculated as: (\[sum of all visits for all individuals during the follow-up period\] / \[sum of follow-up on-treatment time in years (365 days) for all individuals\]).

Outcome measures

Outcome measures
Measure
Tiotropium Bromide/Olodaterol (TIO/OLO)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with TIO/OLO initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the TIO/OLO pharmacy claim that started the ≥30 consecutive days with the medication.
Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with FF/UMEC/VI initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the FF/UMEC/VI pharmacy claim that started the ≥30 consecutive days with the medication.
COPD and/or Pneumonia-related Health Care Resource Utilization
Ambulatory visits
9.01 visits/year
Interval 8.54 to 9.48
9.85 visits/year
Interval 9.33 to 10.37
COPD and/or Pneumonia-related Health Care Resource Utilization
Office visits
4.04 visits/year
Interval 3.91 to 4.16
4.19 visits/year
Interval 4.06 to 4.33
COPD and/or Pneumonia-related Health Care Resource Utilization
Outpatient visits
4.98 visits/year
Interval 4.55 to 5.42
5.67 visits/year
Interval 5.19 to 6.15
COPD and/or Pneumonia-related Health Care Resource Utilization
Emergency room visits
0.70 visits/year
Interval 0.63 to 0.76
0.70 visits/year
Interval 0.64 to 0.76
COPD and/or Pneumonia-related Health Care Resource Utilization
Inpatient visits
0.40 visits/year
Interval 0.37 to 0.43
0.45 visits/year
Interval 0.42 to 0.49
COPD and/or Pneumonia-related Health Care Resource Utilization
Other medical visits
4.36 visits/year
Interval 4.11 to 4.61
4.94 visits/year
Interval 4.68 to 5.2

PRIMARY outcome

Timeframe: Follow-up period (started on the day after the index date, with a minimum of 30-days duration (index date + 1 through index date+30) up to a maximum of 12 months duration (index date + 1 through index date +365).

Population: Matched Overall Population: Stratified propensity score matching (PSM), using an exact match on some variables and a propensity score match on the others, was used to control for possible confounding of the association between the outcomes and treatment with TIO/OLO or FF/UMEC/VI. Patients were matched in a 1:1 ratio of TIO/OLO to FF/UMEC/VI.

Chronic Obstructive Pulmonary Disease (COPD) and/or pneumonia-related health care resource utilization (medical claims with a diagnosis for COPD, pneumonia, or acute bronchitis/bronchiolitis in any position and pharmacy claims for a COPD-related treatment, including COPD-guideline recommended antibiotics). Population annualized averages of inpatient days is reported. Population annualized averages of inpatient days were calculated as: (\[sum of all inpatient days for all individuals during the follow-up period\] / \[sum of follow-up on-treatment time in years (365 days) for all individuals\]).

Outcome measures

Outcome measures
Measure
Tiotropium Bromide/Olodaterol (TIO/OLO)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with TIO/OLO initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the TIO/OLO pharmacy claim that started the ≥30 consecutive days with the medication.
Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with FF/UMEC/VI initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the FF/UMEC/VI pharmacy claim that started the ≥30 consecutive days with the medication.
COPD and/or Pneumonia-related Health Care Resource Utilization: Inpatient Days
3.97 inpatient days/year
Interval 3.49 to 4.45
4.49 inpatient days/year
Interval 3.94 to 5.05

PRIMARY outcome

Timeframe: Follow-up period (started on the day after the index date, with a minimum of 30-days duration (index date + 1 through index date+30) up to a maximum of 12 months duration (index date + 1 through index date +365).

Population: Matched Overall Population: Stratified propensity score matching (PSM), using an exact match on some variables and a propensity score match on the others, was used to control for possible confounding of the association between the outcomes and treatment with TIO/OLO or FF/UMEC/VI. Patients were matched in a 1:1 ratio of TIO/OLO to FF/UMEC/VI.

Chronic Obstructive Pulmonary Disease (COPD) and/or pneumonia-related health care resource utilization (medical claims with a diagnosis for COPD, pneumonia, or acute bronchitis/bronchiolitis in any position and pharmacy claims for a COPD-related treatment, including COPD-guideline recommended antibiotics). Population annualized averages of pharmacy fills is reported. Population annualized averages of pharmacy fills were calculated as: (\[sum of all pharmacy fills for all individuals during the follow-up period\] / \[sum of follow-up on-treatment time in years (365 days) for all individuals\]).

Outcome measures

Outcome measures
Measure
Tiotropium Bromide/Olodaterol (TIO/OLO)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with TIO/OLO initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the TIO/OLO pharmacy claim that started the ≥30 consecutive days with the medication.
Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with FF/UMEC/VI initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the FF/UMEC/VI pharmacy claim that started the ≥30 consecutive days with the medication.
COPD and/or Pneumonia-related Health Care Resource Utilization: Pharmacy Fills
15.48 pharmacy fills/year
Interval 15.2 to 15.77
15.08 pharmacy fills/year
Interval 14.82 to 15.35

PRIMARY outcome

Timeframe: Follow-up period (started on the day after the index date, with a minimum of 30-days duration (index date + 1 through index date+30) up to a maximum of 12 months duration (index date + 1 through index date +365).

Population: Matched Overall Population: Stratified propensity score matching (PSM), using an exact match on some variables and a propensity score match on the others, was used to control for possible confounding of the association between the outcomes and treatment with TIO/OLO or FF/UMEC/VI. Patients were matched in a 1:1 ratio of TIO/OLO to FF/UMEC/VI.

Pneumonia-related health care resource utilization: This utilization was calculated for medical claims with a diagnosis for pneumonia in any position. Population annualized averages of visits in each of the following categories is reported: * Ambulatory visits * Office visits * Outpatient visits * Emergency room visits * Inpatient visits * Other medical visits (independent laboratory, home health, durable medical equipment, etc.) Population annualized averages of visits were calculated as: (\[sum of all visits for all individuals during the follow-up period\] / \[sum of follow-up on-treatment time in years (365 days) for all individuals\]).

Outcome measures

Outcome measures
Measure
Tiotropium Bromide/Olodaterol (TIO/OLO)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with TIO/OLO initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the TIO/OLO pharmacy claim that started the ≥30 consecutive days with the medication.
Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with FF/UMEC/VI initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the FF/UMEC/VI pharmacy claim that started the ≥30 consecutive days with the medication.
Pneumonia-related Health Care Resource Utilization
Ambulatory visits
0.49 visits/year
Interval 0.38 to 0.59
0.66 visits/year
Interval 0.51 to 0.81
Pneumonia-related Health Care Resource Utilization
Emergency room visits
0.10 visits/year
Interval 0.08 to 0.11
0.11 visits/year
Interval 0.09 to 0.13
Pneumonia-related Health Care Resource Utilization
Inpatient visits
0.12 visits/year
Interval 0.1 to 0.13
0.15 visits/year
Interval 0.13 to 0.17
Pneumonia-related Health Care Resource Utilization
Office visits
0.13 visits/year
Interval 0.1 to 0.15
0.15 visits/year
Interval 0.13 to 0.18
Pneumonia-related Health Care Resource Utilization
Outpatient visits
0.36 visits/year
Interval 0.26 to 0.46
0.50 visits/year
Interval 0.37 to 0.64
Pneumonia-related Health Care Resource Utilization
Other medical visits
0.12 visits/year
Interval 0.07 to 0.16
0.12 visits/year
Interval 0.09 to 0.16

PRIMARY outcome

Timeframe: Follow-up period (started on the day after the index date, with a minimum of 30-days duration (index date + 1 through index date+30) up to a maximum of 12 months duration (index date + 1 through index date +365).

Population: Matched Overall Population: Stratified propensity score matching (PSM), using an exact match on some variables and a propensity score match on the others, was used to control for possible confounding of the association between the outcomes and treatment with TIO/OLO or FF/UMEC/VI. Patients were matched in a 1:1 ratio of TIO/OLO to FF/UMEC/VI.

Pneumonia-related health care resource utilization: This utilization was calculated for medical claims with a diagnosis for pneumonia in any position. Population annualized averages of inpatient days is reported. Population annualized averages of inpatient days were calculated as: (\[sum of all inpatient days for all individuals during the follow-up period\] / \[sum of follow-up on-treatment time in years (365 days) for all individuals\]).

Outcome measures

Outcome measures
Measure
Tiotropium Bromide/Olodaterol (TIO/OLO)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with TIO/OLO initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the TIO/OLO pharmacy claim that started the ≥30 consecutive days with the medication.
Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with FF/UMEC/VI initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the FF/UMEC/VI pharmacy claim that started the ≥30 consecutive days with the medication.
Pneumonia-related Health Care Resource Utilization: Inpatient Days
1.72 inpatient days/year
Interval 1.36 to 2.08
1.98 inpatient days/year
Interval 1.56 to 2.4

PRIMARY outcome

Timeframe: Follow-up period (started on the day after the index date, with a minimum of 30-days duration (index date + 1 through index date+30) up to a maximum of 12 months duration (index date + 1 through index date +365).

Population: Matched Overall Population: Stratified propensity score matching (PSM), using an exact match on some variables and a propensity score match on the others, was used to control for possible confounding of the association between the outcomes and treatment with TIO/OLO or FF/UMEC/VI. Patients were matched in a 1:1 ratio of TIO/OLO to FF/UMEC/VI.

COPD or pneumonia-attributable health care resource utilization: This utilization was calculated for medical claims with a diagnosis for COPD, pneumonia, or acute bronchitis/bronchiolitis in the primary position or a diagnosis for acute respiratory failure in the primary position and a diagnosis for COPD, pneumonia, or acute bronchitis/bronchiolitis in a non-primary position and pharmacy claims for a COPD-related treatment, including COPD-guideline recommended antibiotics. Population annualized averages of visits in each of the following categories is reported: * Ambulatory visits * Office visits * Outpatient visits * Emergency room visits * Inpatient visits * Other medical visits (independent laboratory, home health, durable medical equipment, etc.) Population annualized averages of visits were calculated as: (\[sum of all visits for all individuals during the follow-up period\] / \[sum of follow-up on-treatment time in years (365 days) for all individuals\]).

Outcome measures

Outcome measures
Measure
Tiotropium Bromide/Olodaterol (TIO/OLO)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with TIO/OLO initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the TIO/OLO pharmacy claim that started the ≥30 consecutive days with the medication.
Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with FF/UMEC/VI initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the FF/UMEC/VI pharmacy claim that started the ≥30 consecutive days with the medication.
COPD or Pneumonia-attributable Health Care Resource Utilization
Ambulatory visits
4.20 visits/year
Interval 3.94 to 4.46
4.90 visits/year
Interval 4.55 to 5.25
COPD or Pneumonia-attributable Health Care Resource Utilization
Other medical visits
3.82 visits/year
Interval 3.58 to 4.05
4.27 visits/year
Interval 4.03 to 4.51
COPD or Pneumonia-attributable Health Care Resource Utilization
Office visits
2.09 visits/year
Interval 2.0 to 2.17
2.14 visits/year
Interval 2.05 to 2.23
COPD or Pneumonia-attributable Health Care Resource Utilization
Outpatient visits
2.12 visits/year
Interval 1.88 to 2.35
2.77 visits/year
Interval 2.44 to 3.1
COPD or Pneumonia-attributable Health Care Resource Utilization
Emergency room visits
0.29 visits/year
Interval 0.25 to 0.32
0.26 visits/year
Interval 0.23 to 0.3
COPD or Pneumonia-attributable Health Care Resource Utilization
Inpatient visits
0.24 visits/year
Interval 0.21 to 0.26
0.25 visits/year
Interval 0.23 to 0.28

PRIMARY outcome

Timeframe: Follow-up period (started on the day after the index date, with a minimum of 30-days duration (index date + 1 through index date+30) up to a maximum of 12 months duration (index date + 1 through index date +365).

Population: Matched Overall Population: Stratified propensity score matching (PSM), using an exact match on some variables and a propensity score match on the others, was used to control for possible confounding of the association between the outcomes and treatment with TIO/OLO or FF/UMEC/VI. Patients were matched in a 1:1 ratio of TIO/OLO to FF/UMEC/VI.

COPD or pneumonia-attributable health care resource utilization: This utilization was calculated for medical claims with a diagnosis for COPD, pneumonia, or acute bronchitis/bronchiolitis in the primary position or a diagnosis for acute respiratory failure in the primary position and a diagnosis for COPD, pneumonia, or acute bronchitis/bronchiolitis in a non-primary position and pharmacy claims for a COPD-related treatment, including COPD-guideline recommended antibiotics. Population annualized averages of inpatient days is reported. Population annualized averages of inpatient days were calculated as: (\[sum of all inpatient days for all individuals during the follow-up period\] / \[sum of follow-up on-treatment time in years (365 days) for all individuals\]).

Outcome measures

Outcome measures
Measure
Tiotropium Bromide/Olodaterol (TIO/OLO)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with TIO/OLO initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the TIO/OLO pharmacy claim that started the ≥30 consecutive days with the medication.
Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with FF/UMEC/VI initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the FF/UMEC/VI pharmacy claim that started the ≥30 consecutive days with the medication.
COPD or Pneumonia-attributable Health Care Resource Utilization: Inpatient Days
2.87 inpatient days/year
Interval 2.43 to 3.31
3.08 inpatient days/year
Interval 2.59 to 3.58

PRIMARY outcome

Timeframe: Follow-up period (started on the day after the index date, with a minimum of 30-days duration (index date + 1 through index date+30) up to a maximum of 12 months duration (index date + 1 through index date +365).

Population: Matched Overall Population: Stratified propensity score matching (PSM), using an exact match on some variables and a propensity score match on the others, was used to control for possible confounding of the association between the outcomes and treatment with TIO/OLO or FF/UMEC/VI. Patients were matched in a 1:1 ratio of TIO/OLO to FF/UMEC/VI.

COPD or pneumonia-attributable health care resource utilization: This utilization was calculated for medical claims with a diagnosis for COPD, pneumonia, or acute bronchitis/bronchiolitis in the primary position or a diagnosis for acute respiratory failure in the primary position and a diagnosis for COPD, pneumonia, or acute bronchitis/bronchiolitis in a non-primary position and pharmacy claims for a COPD-related treatment, including COPD-guideline recommended antibiotics. Annualized population averages for pharmacy claims are calculated as the (\[sum of all pharmacy fills for all individuals during the follow-up period\] / \[sum of follow-up on-treatment time in years (365 days) for all individuals\]). Wald 95% confidence limits for this ratio used the Taylor expansion to estimate the standard error.

Outcome measures

Outcome measures
Measure
Tiotropium Bromide/Olodaterol (TIO/OLO)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with TIO/OLO initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the TIO/OLO pharmacy claim that started the ≥30 consecutive days with the medication.
Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with FF/UMEC/VI initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the FF/UMEC/VI pharmacy claim that started the ≥30 consecutive days with the medication.
COPD or Pneumonia-attributable Health Care Resource Utilization: Pharmacy Fills
15.48 pharmacy fills/year
Interval 15.2 to 15.77
15.08 pharmacy fills/year
Interval 14.82 to 15.35

PRIMARY outcome

Timeframe: Follow-up period (started on the day after the index date, with a minimum of 30-days duration (index date + 1 through index date+30) up to a maximum of 12 months duration (index date + 1 through index date +365).

Population: Matched Overall Population: Stratified propensity score matching (PSM), using an exact match on some variables and a propensity score match on the others, was used to control for possible confounding of the association between the outcomes and treatment with TIO/OLO or FF/UMEC/VI. Patients were matched in a 1:1 ratio of TIO/OLO to FF/UMEC/VI.

All-cause health care costs were computed from the payer and patient perspective together. Annualized population averages of all-cause health care costs in each of the following categories is reported: * Medical costs (includes physician office costs, hospital outpatient costs, emergency services costs, inpatient costs, and other costs) * Ambulatory * Office visits * Outpatient visits * Emergency room visits * Inpatient stay * Other medical costs * Pharmacy costs * Total (medical + pharmacy) costs. Annualized population averages of costs were calculated as: (\[sum of all costs for all individuals during the follow-up period\] / \[sum of follow-up on-treatment time in years (365 days) for all individuals\]). Costs were adjusted to 2020 dollars using the most recent year of the medical care component of the Consumer Price Index (CPI) to reflect inflation between the date of the claim and 2020.

Outcome measures

Outcome measures
Measure
Tiotropium Bromide/Olodaterol (TIO/OLO)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with TIO/OLO initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the TIO/OLO pharmacy claim that started the ≥30 consecutive days with the medication.
Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with FF/UMEC/VI initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the FF/UMEC/VI pharmacy claim that started the ≥30 consecutive days with the medication.
All-cause Health Care Costs (Insurer + Patient Paid Amounts)
Medical costs
16911.48 dollars/year
Interval 15847.98 to 17974.99
18471.61 dollars/year
Interval 17239.5 to 19703.71
All-cause Health Care Costs (Insurer + Patient Paid Amounts)
Ambulatory costs
7321.14 dollars/year
Interval 6778.92 to 7863.36
7858.06 dollars/year
Interval 7294.85 to 8421.27
All-cause Health Care Costs (Insurer + Patient Paid Amounts)
Office visits costs
2986.46 dollars/year
Interval 2689.18 to 3283.74
3030.56 dollars/year
Interval 2747.15 to 3313.97
All-cause Health Care Costs (Insurer + Patient Paid Amounts)
Outpatient visits costs
4334.68 dollars/year
Interval 3904.48 to 4764.88
4827.50 dollars/year
Interval 4373.94 to 5281.07
All-cause Health Care Costs (Insurer + Patient Paid Amounts)
Emergency room visits costs
991.35 dollars/year
Interval 905.13 to 1077.57
1086.48 dollars/year
Interval 985.78 to 1187.18
All-cause Health Care Costs (Insurer + Patient Paid Amounts)
Inpatient stay costs
7480.17 dollars/year
Interval 6676.49 to 8283.85
8139.51 dollars/year
Interval 7219.72 to 9059.31
All-cause Health Care Costs (Insurer + Patient Paid Amounts)
Other medical costs
1118.83 dollars/year
Interval 1030.7 to 1206.95
1387.55 dollars/year
Interval 1127.1 to 1648.01
All-cause Health Care Costs (Insurer + Patient Paid Amounts)
Pharmacy costs
10192.10 dollars/year
Interval 9694.69 to 10689.5
11963.02 dollars/year
Interval 11348.38 to 12577.66
All-cause Health Care Costs (Insurer + Patient Paid Amounts)
Total (medical + pharmacy) costs
27103.58 dollars/year
Interval 25871.2 to 28335.96
30434.63 dollars/year
Interval 29019.36 to 31849.89

PRIMARY outcome

Timeframe: Follow-up period (started on the day after the index date, with a minimum of 30-days duration (index date + 1 through index date+30) up to a maximum of 12 months duration (index date + 1 through index date +365).

Population: Matched Overall Population: Stratified propensity score matching (PSM), using an exact match on some variables and a propensity score match on the others, was used to control for possible confounding of the association between the outcomes and treatment with TIO/OLO or FF/UMEC/VI. Patients were matched in a 1:1 ratio of TIO/OLO to FF/UMEC/VI.

COPD-related health care costs (HCC) cover the costs for medical claims with a diagnosis for COPD in any position and pharmacy claims for a COPD-related treatment, including COPD-guideline recommended antibiotics. Annualized population averages of COPD-related HCC for the categories below are reported: * Medical costs (includes physician office costs, hospital outpatient costs, emergency services costs, inpatient costs, and other costs) * Ambulatory * Office visits * Outpatient visits * Emergency room visits * Inpatient stay * Other medical costs * Pharmacy costs * Total (medical + pharmacy) costs. Annualized population averages of costs = (\[sum of all costs for all individuals during the follow-up period\] / \[sum of follow-up on-treatment time in years (365 days) for all individuals\]). Costs are adjusted to 2020 dollars using the most recent year of the medical care component of the Consumer Price Index (CPI) to reflect inflation between the claim date and 2020.

Outcome measures

Outcome measures
Measure
Tiotropium Bromide/Olodaterol (TIO/OLO)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with TIO/OLO initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the TIO/OLO pharmacy claim that started the ≥30 consecutive days with the medication.
Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with FF/UMEC/VI initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the FF/UMEC/VI pharmacy claim that started the ≥30 consecutive days with the medication.
COPD-related Health Care Costs (Insurer + Patient Paid Amounts)
Outpatient visits costs
1619.49 dollars/year
Interval 1398.51 to 1840.48
1784.78 dollars/year
Interval 1608.97 to 1960.6
COPD-related Health Care Costs (Insurer + Patient Paid Amounts)
Pharmacy costs
4729.11 dollars/year
Interval 4675.71 to 4782.5
6567.16 dollars/year
Interval 6502.52 to 6631.79
COPD-related Health Care Costs (Insurer + Patient Paid Amounts)
Medical costs
9635.45 dollars/year
Interval 8796.38 to 10474.52
10820.05 dollars/year
Interval 9863.73 to 11776.36
COPD-related Health Care Costs (Insurer + Patient Paid Amounts)
Ambulatory costs
2088.43 dollars/year
Interval 1865.2 to 2311.66
2278.21 dollars/year
Interval 2098.69 to 2457.72
COPD-related Health Care Costs (Insurer + Patient Paid Amounts)
Office visits costs
468.94 dollars/year
Interval 449.67 to 488.21
493.42 dollars/year
Interval 469.73 to 517.12
COPD-related Health Care Costs (Insurer + Patient Paid Amounts)
Emergency room visits costs
426.02 dollars/year
Interval 377.61 to 474.42
455.87 dollars/year
Interval 398.69 to 513.05
COPD-related Health Care Costs (Insurer + Patient Paid Amounts)
Inpatient stay costs
6681.35 dollars/year
Interval 5910.54 to 7452.17
7596.04 dollars/year
Interval 6700.88 to 8491.21
COPD-related Health Care Costs (Insurer + Patient Paid Amounts)
Other medical costs
439.65 dollars/year
Interval 400.07 to 479.23
489.92 dollars/year
Interval 416.29 to 563.56
COPD-related Health Care Costs (Insurer + Patient Paid Amounts)
Total (medical + pharmacy) costs
14364.56 dollars/year
Interval 13521.68 to 15207.44
17387.20 dollars/year
Interval 16425.26 to 18349.15

PRIMARY outcome

Timeframe: Follow-up period (started on the day after the index date, with a minimum of 30-days duration (index date + 1 through index date+30) up to a maximum of 12 months duration (index date + 1 through index date +365).

Population: Matched Overall Population: Stratified propensity score matching (PSM), using an exact match on some variables and a propensity score match on the others, was used to control for possible confounding of the association between the outcomes and treatment with TIO/OLO or FF/UMEC/VI. Patients were matched in a 1:1 ratio of TIO/OLO to FF/UMEC/VI.

These costs were calculated for medical claims with a diagnosis for COPD, pneumonia, or acute bronchitis/bronchiolitis in any position and pharmacy claims for a COPD-related treatment, including COPD-guideline recommended antibiotics. Annualized population averages of costs for categories below is reported: * Medical costs (includes physician office costs, hospital outpatient costs, emergency services costs, inpatient costs, and other costs) * Ambulatory * Office visits * Outpatient visits * Emergency room visits * Inpatient stay * Other medical costs * Pharmacy costs * Total (medical + pharmacy) costs. Annualized population averages=(\[sum of all costs for all individuals during the follow-up period\] / \[sum of follow-up on-treatment time in years (365 days) for all individuals\]). Costs were adjusted to 2020 dollars using the most recent year of the medical care component of the Consumer Price Index (CPI) to reflect inflation between the claim date and 2020.

Outcome measures

Outcome measures
Measure
Tiotropium Bromide/Olodaterol (TIO/OLO)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with TIO/OLO initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the TIO/OLO pharmacy claim that started the ≥30 consecutive days with the medication.
Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with FF/UMEC/VI initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the FF/UMEC/VI pharmacy claim that started the ≥30 consecutive days with the medication.
COPD and/or Pneumonia-related Health Care Costs (Insurer + Patient Paid Amounts)
Ambulatory costs
2121.76 dollars/year
Interval 1897.95 to 2345.56
2316.77 dollars/year
Interval 2136.31 to 2497.23
COPD and/or Pneumonia-related Health Care Costs (Insurer + Patient Paid Amounts)
Office visits costs
481.16 dollars/year
Interval 461.7 to 500.62
508.60 dollars/year
Interval 484.54 to 532.65
COPD and/or Pneumonia-related Health Care Costs (Insurer + Patient Paid Amounts)
Medical costs
9828.60 dollars/year
Interval 8983.51 to 10673.68
11065.38 dollars/year
Interval 10099.14 to 12031.62
COPD and/or Pneumonia-related Health Care Costs (Insurer + Patient Paid Amounts)
Outpatient visits costs
1640.60 dollars/year
Interval 1419.1 to 1862.09
1808.18 dollars/year
Interval 1631.62 to 1984.73
COPD and/or Pneumonia-related Health Care Costs (Insurer + Patient Paid Amounts)
Emergency room visits costs
448.83 dollars/year
Interval 399.54 to 498.12
482.53 dollars/year
Interval 423.81 to 541.26
COPD and/or Pneumonia-related Health Care Costs (Insurer + Patient Paid Amounts)
Inpatient stay costs
6811.63 dollars/year
Interval 6036.18 to 7587.08
7769.37 dollars/year
Interval 6865.53 to 8673.21
COPD and/or Pneumonia-related Health Care Costs (Insurer + Patient Paid Amounts)
Other medical costs
446.38 dollars/year
Interval 406.5 to 486.26
496.70 dollars/year
Interval 422.8 to 570.6
COPD and/or Pneumonia-related Health Care Costs (Insurer + Patient Paid Amounts)
Pharmacy costs
4729.11 dollars/year
Interval 4675.71 to 4782.5
6567.16 dollars/year
Interval 6502.52 to 6631.79
COPD and/or Pneumonia-related Health Care Costs (Insurer + Patient Paid Amounts)
Total (medical + pharmacy) costs
14557.70 dollars/year
Interval 13708.73 to 15406.67
17632.54 dollars/year
Interval 16660.65 to 18604.43

PRIMARY outcome

Timeframe: Follow-up period (started on the day after the index date, with a minimum of 30-days duration (index date + 1 through index date+30) up to a maximum of 12 months duration (index date + 1 through index date +365).

Population: Matched Overall Population: Stratified propensity score matching (PSM), using an exact match on some variables and a propensity score match on the others, was used to control for possible confounding of the association between the outcomes and treatment with TIO/OLO or FF/UMEC/VI. Patients were matched in a 1:1 ratio of TIO/OLO to FF/UMEC/VI.

These costs were calculated for medical claims with a diagnosis for pneumonia in any position. Annualized population averages of pneumonia-related health care costs for the categories below is reported: * Medical costs (includes physician office costs, hospital outpatient costs, emergency services costs, inpatient costs, and other costs) * Ambulatory * Office visits * Outpatient visits * Emergency room visits * Inpatient stay * Other medical costs * Pharmacy costs * Total (medical + pharmacy) costs. Annualized population averages=(\[sum of all costs for all individuals during the follow-up period\] / \[sum of follow-up on-treatment time in years (365 days) for all individuals\]). Costs were adjusted to 2020 dollars using the most recent year of the medical care component of the Consumer Price Index (CPI) to reflect inflation between the claim date and 2020.

Outcome measures

Outcome measures
Measure
Tiotropium Bromide/Olodaterol (TIO/OLO)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with TIO/OLO initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the TIO/OLO pharmacy claim that started the ≥30 consecutive days with the medication.
Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with FF/UMEC/VI initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the FF/UMEC/VI pharmacy claim that started the ≥30 consecutive days with the medication.
Pneumonia-related Health Care Costs (Insurer + Patient Paid Amounts)
Office visits costs
15.03 dollars/year
Interval 11.95 to 18.12
18.03 dollars/year
Interval 14.56 to 21.5
Pneumonia-related Health Care Costs (Insurer + Patient Paid Amounts)
Emergency room visits costs
48.91 dollars/year
Interval 34.33 to 63.5
51.33 dollars/year
Interval 37.3 to 65.37
Pneumonia-related Health Care Costs (Insurer + Patient Paid Amounts)
Medical costs
2857.23 dollars/year
Interval 2293.89 to 3420.58
3466.72 dollars/year
Interval 2751.82 to 4181.63
Pneumonia-related Health Care Costs (Insurer + Patient Paid Amounts)
Ambulatory costs
80.62 dollars/year
Interval 55.7 to 105.55
98.19 dollars/year
Interval 74.68 to 121.69
Pneumonia-related Health Care Costs (Insurer + Patient Paid Amounts)
Inpatient stay costs
2714.94 dollars/year
Interval 2156.01 to 3273.86
3297.65 dollars/year
Interval 2588.62 to 4006.67
Pneumonia-related Health Care Costs (Insurer + Patient Paid Amounts)
Outpatient visits costs
65.59 dollars/year
Interval 42.03 to 89.14
80.16 dollars/year
Interval 57.88 to 102.44
Pneumonia-related Health Care Costs (Insurer + Patient Paid Amounts)
Other medical costs
12.77 dollars/year
Interval 3.6 to 21.93
19.56 dollars/year
Interval -1.1 to 40.21
Pneumonia-related Health Care Costs (Insurer + Patient Paid Amounts)
Total (medical + pharmacy) costs
2857.23 dollars/year
Interval 2293.89 to 3420.58
3466.72 dollars/year
Interval 2751.82 to 4181.63

PRIMARY outcome

Timeframe: Follow-up period (started on the day after the index date, with a minimum of 30-days duration (index date + 1 through index date+30) up to a maximum of 12 months duration (index date + 1 through index date +365).

Population: Matched Overall Population: Stratified propensity score matching (PSM), using an exact match on some variables and a propensity score match on the others, was used to control for possible confounding of the association between the outcomes and treatment with TIO/OLO or FF/UMEC/VI. Patients were matched in a 1:1 ratio of TIO/OLO to FF/UMEC/VI.

These costs were calculated for medical claims with a diagnosis for COPD, pneumonia, or acute bronchitis/bronchiolitis in the primary position or a diagnosis for acute respiratory failure in the primary position and a diagnosis for COPD, pneumonia, or acute bronchitis/bronchiolitis in a non-primary position, or pharmacy claims for a COPD-related treatment, including COPD-guideline recommended antibiotics. Annualized population averages are reported and were calculated as=(\[sum of all costs for all individuals during the follow-up period\] / \[sum of follow-up on-treatment time in years (365 days) for all individuals\]). Costs were adjusted to 2020 dollars using the most recent year of the medical care component of the Consumer Price Index (CPI) to reflect inflation between the claim date and 2020.

Outcome measures

Outcome measures
Measure
Tiotropium Bromide/Olodaterol (TIO/OLO)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with TIO/OLO initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the TIO/OLO pharmacy claim that started the ≥30 consecutive days with the medication.
Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with FF/UMEC/VI initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the FF/UMEC/VI pharmacy claim that started the ≥30 consecutive days with the medication.
COPD or Pneumonia-attributable Health Care Costs (Insurer + Patient Paid Amounts)
Medical costs
5630.81 dollars/year
Interval 4935.27 to 6326.35
6006.47 dollars/year
Interval 5207.4 to 6805.54
COPD or Pneumonia-attributable Health Care Costs (Insurer + Patient Paid Amounts)
Ambulatory costs
517.27 dollars/year
Interval 476.44 to 558.11
623.53 dollars/year
Interval 571.43 to 675.62
COPD or Pneumonia-attributable Health Care Costs (Insurer + Patient Paid Amounts)
Office visits costs
231.09 dollars/year
Interval 220.79 to 241.39
242.99 dollars/year
Interval 231.84 to 254.15
COPD or Pneumonia-attributable Health Care Costs (Insurer + Patient Paid Amounts)
Outpatient visits costs
286.18 dollars/year
Interval 247.81 to 324.55
380.53 dollars/year
Interval 330.93 to 430.14
COPD or Pneumonia-attributable Health Care Costs (Insurer + Patient Paid Amounts)
Emergency room visits costs
153.87 dollars/year
Interval 128.27 to 179.47
130.00 dollars/year
Interval 107.47 to 152.53
COPD or Pneumonia-attributable Health Care Costs (Insurer + Patient Paid Amounts)
Inpatient stay costs
4595.72 dollars/year
Interval 3912.28 to 5279.16
4885.72 dollars/year
Interval 4099.84 to 5671.61
COPD or Pneumonia-attributable Health Care Costs (Insurer + Patient Paid Amounts)
Other medical costs
363.95 dollars/year
Interval 332.48 to 395.42
367.22 dollars/year
Interval 333.81 to 400.62
COPD or Pneumonia-attributable Health Care Costs (Insurer + Patient Paid Amounts)
Pharmacy costs
4729.11 dollars/year
Interval 4675.71 to 4782.5
6567.16 dollars/year
Interval 6502.52 to 6631.79
COPD or Pneumonia-attributable Health Care Costs (Insurer + Patient Paid Amounts)
Total (medical + pharmacy) costs
10359.92 dollars/year
Interval 9659.97 to 11059.86
12573.62 dollars/year
Interval 11768.74 to 13378.51

PRIMARY outcome

Timeframe: Follow-up period (started on the day after the index date, with a minimum of 30-days duration (index date + 1 through index date+30) up to a maximum of 12 months duration (index date + 1 through index date +365).

Population: Matched Overall Population: Stratified propensity score matching (PSM), using an exact match on some variables and a propensity score match on the others, was used to control for possible confounding of the association between the outcomes and treatment with TIO/OLO or FF/UMEC/VI. Patients were matched in a 1:1 ratio of TIO/OLO to FF/UMEC/VI.

Annualized population averages of COPD exacerbations for the categories below are reported: * Any COPD exacerbation * Severe COPD exacerbation (defined as an inpatient admission or an emergency room (ER) visit with a COPD diagnosis code in the primary position; or an inpatient admission or an ER visit with a diagnosis code for acute respiratory failure in the primary position and a COPD diagnosis code in any position; or an inpatient admission or an ER visit with a diagnosis code for acute respiratory failure in the primary position + an inpatient admission or an ER visit within ±7 days with a COPD diagnosis code in any position). Annualized population averages= (\[sum of all exacerbations for all individuals during the follow-up period\] / \[sum of follow-up on-treatment time in years (365 days) for all individuals\]).

Outcome measures

Outcome measures
Measure
Tiotropium Bromide/Olodaterol (TIO/OLO)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with TIO/OLO initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the TIO/OLO pharmacy claim that started the ≥30 consecutive days with the medication.
Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI)
n=5658 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with FF/UMEC/VI initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the FF/UMEC/VI pharmacy claim that started the ≥30 consecutive days with the medication.
Chronic Obstructive Pulmonary Disease (COPD) Exacerbations
Any COPD exacerbation
1.02 exacerbations/year
Interval 0.97 to 1.08
0.98 exacerbations/year
Interval 0.92 to 1.03
Chronic Obstructive Pulmonary Disease (COPD) Exacerbations
Severe COPD exacerbation
0.28 exacerbations/year
Interval 0.25 to 0.3
0.26 exacerbations/year
Interval 0.24 to 0.29

SECONDARY outcome

Timeframe: Follow-up period (started on the day after the index date, with a minimum of 30-days duration (index date + 1 through index date+30) up to a maximum of 12 months duration (index date + 1 through index date +365).

Population: Patients in the Matched Overall Population with a COPD hospitalization during the follow-up period. Matched Overall Population: Stratified propensity score matching (PSM), using an exact match on some variables and a propensity score match on the others, was used to control for possible confounding of the association between the outcomes and treatment with TIO/OLO or FF/UMEC/VI. Patients were matched in a 1:1 ratio of TIO/OLO to FF/UMEC/VI.

Percentage of patients with 30-day all-cause readmission after Chronic Obstructive Pulmonary Disease (COPD) hospitalization is reported. Hospitalizations were classified as COPD-related if they met either of the following 2 criteria: * ≥1 diagnosis of COPD in the primary position any time during the acute inpatient stay; or * ≥1 diagnosis of acute respiratory failure in the primary position and a diagnosis of acute exacerbation of COPD in a later position on the same claim during an acute inpatient stay.

Outcome measures

Outcome measures
Measure
Tiotropium Bromide/Olodaterol (TIO/OLO)
n=191 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with TIO/OLO initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the TIO/OLO pharmacy claim that started the ≥30 consecutive days with the medication.
Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI)
n=400 Participants
Chronic Obstructive Pulmonary Disease (COPD) patients with ≥30 consecutive days with FF/UMEC/VI initiated during the patient identification period of 01 June 2015 to 30 November 2019 and ≥40 years of age as of the year of the index date. The index date was the date of the FF/UMEC/VI pharmacy claim that started the ≥30 consecutive days with the medication.
Percentage of Patients With 30-day All-cause Readmission After COPD Hospitalization
12.04 percentage of patients
18.25 percentage of patients

Adverse Events

Tiotropium Bromide/Olodaterol (TIO/OLO)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Boehringer Ingelheim, Call Center

Boehringer Ingelheim

Phone: 1-800-243-0127

Results disclosure agreements

  • Principal investigator is a sponsor employee Boehringer Ingelheim (BI) acknowledges that investigators have the right to publish the study results. Investigators shall provide BI with a copy of any publication or presentation for review prior to any submission. Such review will be done with regard to proprietary information, information related to patentable inventions, medical, scientific, and statistical accuracy within 60 days. BI may request a delay of the publication in order to protect BI's intellectual property rights.
  • Publication restrictions are in place

Restriction type: OTHER