Evaluation of Medication Adherence and Rescue Medication Use in Non-Exacerbating Patients with COPD Receiving Umeclidinium/Vilanterol or Budesonide/Formoterol as Initial Maintenance Therapy

Figures & data

Figure 1 Patient identification period and study design.

Abbreviations: B/F, budesonide/formoterol; UMEC/VI, umeclidinium/vilanterol.

Table 1 Selected Patient Demographics and Clinical Characteristics Before and After IPTW^a

	Before IPTW		After IPTW
	UMEC/VI N=4082	B/F N=9530	UMEC/VI N=4082	B/F N=9529^b	ASD (%)
Age, years, mean (SD)	70.5 (9.8)	70.8 (9.8)	70.5 (9.9)	70.7 (9.8)	1.5
Female, n (%)	1893 (46.4)	4813 (50.5)	2004 (49.1)	4692 (49.2)	0.3
Payer, n (%)
Commercial	812 (19.9)	1337 (14.0)	643 (15.8)	1501 (15.8)	0
Medicare Advantage	3270 (80.1)	8193 (86.0)	3439 (84.2)	8028 (84.2)	0
Geographic region, n (%)
Northeast	424 (10.4)	913 (9.6)	398 (9.7)	931 (9.8)	0.1
North Central	780 (19.1)	1935 (20.3)	802 (19.6)	1895 (19.9)	0.6
South	1993 (48.8)	4285 (45.0)	1896 (46.5)	4399 (46.2)	0.6
West	878 (21.5)	2365 (24.8)	976 (23.9)	2276 (23.9)	0.1
Unknown	7 (0.2)	32 (0.3)	10 (0.2)	27 (0.3)	0.9
Quan-CCI, mean (SD)	3.3 (2.7)	3.2 (2.7)	3.2 (2.7)	3.2 (2.7)	0.1
Fills for respiratory medications^c, n (%)	2133 (52.3)	4874 (51.1)	2113 (51.8)	4908 (51.5)	0.5
Rescue medication units, mean (SD)	1.4 (3.4)	1.4 (3.2)	1.4 (3.3)	1.4 (3.2)	0.4
<6 units, n (%)	3783 (92.7)	8875 (93.1)	3771 (92.4)	8877 (93.2)	2.9
≥6 units, n (%)	299 (7.3)	655 (6.9)	310 (7.6)	652 (6.8)	2.9
COPD severity score, mean (SD)	23.4 (4.5)	23.4 (4.6)	23.4 (4.7)	23.4 (4.6)	0.6
Any COPD-related outpatient visit (n, %)	2284 (56.0)	4280 (44.9)	1945 (47.6)	4585 (48.1)	0.9
Number of COPD-related outpatient days, mean (SD)	1.7 (3.5)	1.6 (3.9)	1.4 (3.4)	1.7 (3.9)	6.8
Any visits with a pulmonologist, n (%)	1553 (38.0)	2156 (22.6)	1113 (27.3)	2594 (27.2)	0.1
Prescription out-of-pocket costs during baseline, $, mean (SD) ^d	659 (876)	621 (919)	640 (848)	634 (943)	0.7
Median (IQR)	412 (171, 847)	390 (150, 750)	403 (162, 819)	395 (154, 767)	-
Medicare Part D low-income subsidy during baseline, n (%)	960 (23.5)	2764 (29.0)	1112 (27.2)	2604 (27.3)	0.2

Notes: ^aA subset of the variables included as covariates in the IPTW model are listed in this table; complete demographics and baseline characteristics data are displayed in Supplementary Table S1. The following variables were included as covariates in the IPTW model: age, sex, insurance plan type, payer, geographic region, Quan-CCI, number of unique pre-index medications, pre-index rescue medication use (SABA, SAMA, SABA/SAMA), pre-index OCS use, pre-index use of other respiratory medications (methylxanthines, PDE4 inhibitors), COPD severity score, index fill from mail-order pharmacy, index fill days supplied ≥90 days, pre-index COPD-related healthcare utilization (emergency department and outpatient visits), pre-index visits with a pulmonologist, inflation-adjusted pharmacy patient out-of-pocket costs for the index controller fill and during the pre-index period, and evidence of Medicare Part D low-income subsidy during the pre-index period; ^bThe sample size in the B/F cohort was reduced by 1 as a result of the stabilized weighting; ^cIncluding SABA, SAMA, SABA/SAMA, methylxanthines, PDE4 inhibitors, or OCS; ^dInflation-adjusted to 2018 USD using the prescription drug component of the Consumer Price Index.

Abbreviations: ASD, absolute standard deviation; B/F, budesonide/formoterol; CCI, Charlson Comorbidity Index; COPD, chronic obstructive pulmonary disease; IPTW, inverse probability of treatment weighting; IQR, interquartile range; OCS, oral corticosteroids; PDE4, phosphodiesterase 4; SABA, short-acting β₂-agonist; SAMA, short-acting muscarinic antagonist; SD, standard deviation; UMEC/VI, umeclidinium/vilanterol.

Figure 2 (A) Mean PDC in the follow-up period with UMEC/VI versus B/F and (B) Percentage of patients achieving adherence (PDC≥0.80).

Abbreviations: B/F, budesonide/formoterol; PDC, proportion of days covered.

Figure 3 Mean difference in canister-equivalent units of rescue medication in the follow-up period. ^aOver the 12-month follow-up period.

Abbreviations: B/F, budesonide/formoterol; CI, confidence interval; UMEC/VI, umeclidinium/vilanterol.