Extent of non-adherence and non-persistence in asthma patients: analysis of a large claims data set

Figures & data

Figure 1. Methodology of non-adherence calculation.

Figure 2. Methodology of non-persistence calculation.

Table 1. Characteristics of observed asthma patient samples.

Characteristics	All included asthma patients	All asthma patients with ≥1 prescription of a long-acting asthma therapy	All asthma patients with ≥2 prescription of the same agent class of long-acting medication in a 12-month period (cohort 1)	Treatment-naïve asthma patients who started an initial long-acting therapy (cohort 2)
N	207,930	71,569	52,508	50,660
Age in years at time of observation; Mean (SD)	36.8 (23.0)	39.1 (23.3)	40.1 (23.6)	39.7 (22.2)
Female gender; N (%)	117,204 (57.7)	41,721 (58.3)	30,651 (58.4)	29,783 (58.8)

Table 2. Extent of non-adherence in patient cohort 1.

		PDC	Average weighted MPR	ICS (MPR)	LABA (MPR)	ICS + LABA (MPR)	LTRA (MPR)
	N	54,064	52,508	25,044	3,220	27,835	7,263
Base case scenario: DDD	MPR/PDC (%)
	Mean	40.4	38.5	31.8	48.6	42.9	56.2
	Median	33.7	33.0	24.4	45.3	38.4	58.8
	% of non-adherent patients
	MPR/PDC ≤ 80%	85.9	89.4	91.8	80.9	86.7	71.6
Sensitivity: chart review based PDD	MPR/PDC (%)
	Mean	54.5	53.1	48.3	64.2	57.7	59.4
	Median	52.5	51.1	42.5	68.4	57.3	63.5
	% of non-adherent patients
	MPR/PDC ≤ 80%	65.2	74.6	75.9	60.8	71.0	65.2

Figure 3. Persistence to long-acting asthma prescription – percentage of patients persistent after therapy initiation (gap >90 days; coverage: DDD).

Figure 4. Persistence to long-acting asthma prescription – percentage of patients persistent after therapy initiation (gap >180 days; coverage: DDD).

Table 3. Extent of non-persistence in patient cohort 2 (treatment naive patients).

		Overall non-persistence	ICS	LABA	ICS + LABA	LTRA
	N	50,660	24,238	2,163	29,208	5,895
Base case scenario: DDD
Gap >90 days	% of non-persistent patients	86.7	94.5	86.7	80.6	85.6
	Drug survival time in days, mean (SD)	114.6 (118.1)	81.7 (91.9)	110.6 (112.7)	138.0 (129.8)	112.8 (120.8)
Gap >180 days	% of non-persistent patients	72.3	86.4	76.3	60.4	79.0
	Drug survival time in days, mean (SD)	159.6 (143.7)	112.2 (121.1)	145.5 (135.8)	197.4 (150.3)	135.1 (135.5)
Sensitivity: chart-review based PDD
Gap >90 days	% of non-persistent patients	78.5	90.1	84.8	71.0	88.2
	Drug survival time in days, mean (SD)	157.3 (129.3)	123,5 (109.0)	138.2 (113.9)	181.0 (135.7)	109.2 (114.5)
Gap >180 days	% of non-persistent patients	66.7	82.5	76.6	56.2	83.2
	Drug survival time in days, mean (SD)	189.2 (140.9)	146.3 (124.5)	161.4 (127.7)	219.0 (142.9)	126.1 (127.4)