The impact of adherence and disease control on resource use and charges in patients with mild asthma managed on inhaled corticosteroid agents

Figures & data

Figure 1 Patient selection. Patients were identified from a commercial insurance database and analyzed retrospectively to identify those with mild asthma who initiated treatment with an ICS. Patients who met all inclusion and exclusion criteria were assigned to 1 of 2 control/adherence cohorts based on the number of exacerbation events and percent days covered in the pre-index period: HCHA, 0 exacerbation events and ≥60% PDC; LCLA, ≥2 exacerbation events and <10% PDC.

*Criterion included owing to the initial existence of a fluticasone propionate with salmeterol cohort, which is not presented in the current analysis.

Abbreviations: ICS, inhaled corticosteroid; HCHA, high control high adherence; LCLA, low control low adherence; PDC, percent days covered.

Table 1 Demographics and characteristics at index date

Demographic or characteristic	HCHA (n = 483)	LCLA (n = 258)	P value
Mean age, y	44.2	33.4	<0.0001
Female, %	61.5	76.4	<0.0001
Mean SABA claims, n	0.50	0.56	0.1844
Asthma days, n	1.7	1.0	<0.0001
Pre-asthma records, n	3.7	1.8	<0.0001
Mean asthma-related charges, $	502	297	<0.0001
Comorbidity, %
Rhinitis	48.0	30.2	<0.0001
Sinusitis	27.5	29.8	0.5065
Upper respiratory infection	15.5	31.4	<0.0001
Acute bronchitis	15.5	18.6	0.2836
GERD	14.1	11.2	0.2752
Pneumonia	2.3	4.3	0.1291
Acute laryngitis	1.7	2.3	0.5238
Acute nasopharyngitis	1.9	1.6	0.7572

Abbreviations: GERD, gastroesophageal reflux disease; HCHA, high control high adherence; LCLA, low control low adherence; SABA, short-acting β₂-agonist.

Figure 2 Resource utilization. The mean number of post-index asthma-related medical records, asthma days, OCS prescriptions, and ICS records among patients assigned to the HCHA or LCLA cohort are depicted. Error bars represent standard error of the mean.

*P < 0.0001.

Abbreviations: HCHA, high control high adherence; ICS, inhaled corticosteroids; LCLA, low control low adherence; OCS, oral corticosteroids.

Figure 3 Asthma-related charges. The mean post-index asthma-related inpatient, outpatient, pharmaceutical, and total charges among patients assigned to the HCHA or LCLA cohort are depicted. Error bars represent standard error of the mean.

*P ≤ 0.0001.

Abbreviations: HCHA, high control high adherence; LCLA, low control low adherence.

Figure 4 ICS use associated with HCHA. The percentages of patients included in the current analysis that were treated with MF, FP, FP HFA, BUD, or BDP and assigned to the HCHA cohort are depicted. Percentages for each ICS group represent the number of patients who were treated with each respective ICS and qualified for the HCHA cohort divided by the total number of patients who were treated with each respective ICS. Error bars represent standard error of the mean.

*P < 0.0001 vs MF.

Abbreviations: BDP, beclomethasone dipropionate; BUD, budesonide; FP, fluticasone propionate; HCHA, high control high adherence; HFA, hydrofluoroalkane; ICS, inhaled corticosteroid; LCLA, low control low adherence; MF, mometasone furoate.