Retrospective Real-World Study Assessing All-Cause and COPD-Related Mortality in Uncontrolled COPD, General COPD, and Non-COPD Patients Using a Large Administrative Claims Database in the US
Author(s)
Ernesto Mayen Herrera, BSc, MSc1, Veleka Allen, PhD1, Shanti Neff-Baro, BA, MSc2, Valentine Laizet, MSc3, Gabriela Friedrich, MSc4.
1Sanofi, Morristown, NJ, USA, 2Amaris, Paris, France, 3Amaris, Montréal, QC, Canada, 4Amaris, Barcelona, Spain.
1Sanofi, Morristown, NJ, USA, 2Amaris, Paris, France, 3Amaris, Montréal, QC, Canada, 4Amaris, Barcelona, Spain.
OBJECTIVES: This retrospective real-world evidence study aimed to evaluate all-cause, chronic obstructive pulmonary disease (COPD)-related mortality and exacerbations in patients with uncontrolled COPD (U-COPD), general COPD (G-COPD), and non-COPD in the US.
METHODS: Patients with ≥2 ICD-10 COPD diagnoses and aged 40-80 years at initial diagnosis (index; termed as G-COPD) were identified from the Merative MarketScan® administrative claims database between January 2018 and December 2022. Of these, U-COPD patients were defined as those who experienced ≥2 moderate (<12 months apart) or ≥1 severe exacerbation(s) during the study period. Non-COPD controls were matched to G-COPD patients by age and gender, and a random index date was imputed. All patients were followed from 1 year prior to index until the end of study or death. Crude and standardised (by age and gender) rates for all-cause, COPD-related mortality (standardised mortality ratios [SMRs]) and exacerbations were generated with 95% confidence intervals (95%CI) for comparison across cohorts.
RESULTS: The study included 226,996 G-COPD, 54,710 U-COPD, and 415,849 non-COPD patients. Baseline demographics were balanced across cohorts; U-COPD patients reported more comorbidities versus non-COPD patients (23.2% vs. 6.8% for history of major adverse cardiac events, 63.4% vs. 41.6% for hypertension). U-COPD patients showed higher all-cause mortality (11.8%) versus G-COPD (8.8%) and non-COPD (1.5%) patients, with SMRs of 1.24 (95%CI: 1.21-1.27) and 2.96 (95%CI: 2.89-3.03), respectively. COPD-related mortality was higher among U-COPD (4.8%) versus G-COPD (2.6%) patients with an SMR of 1.70 (95%CI: 1.63-1.76). Exacerbations occurrence was higher in U-COPD (96.1%) versus G-COPD (43.3%) patients, with SMR of 2.20 (95%CI: 2.19-2.22).
CONCLUSIONS: Patients with U-COPD showed higher all-cause and COPD-related mortality than those with G-COPD and non-COPD, emphasising the need for improved management strategies. The lack of information on potential confounding factors, including eosinophil data and smoking status, may affect the study findings.
METHODS: Patients with ≥2 ICD-10 COPD diagnoses and aged 40-80 years at initial diagnosis (index; termed as G-COPD) were identified from the Merative MarketScan® administrative claims database between January 2018 and December 2022. Of these, U-COPD patients were defined as those who experienced ≥2 moderate (<12 months apart) or ≥1 severe exacerbation(s) during the study period. Non-COPD controls were matched to G-COPD patients by age and gender, and a random index date was imputed. All patients were followed from 1 year prior to index until the end of study or death. Crude and standardised (by age and gender) rates for all-cause, COPD-related mortality (standardised mortality ratios [SMRs]) and exacerbations were generated with 95% confidence intervals (95%CI) for comparison across cohorts.
RESULTS: The study included 226,996 G-COPD, 54,710 U-COPD, and 415,849 non-COPD patients. Baseline demographics were balanced across cohorts; U-COPD patients reported more comorbidities versus non-COPD patients (23.2% vs. 6.8% for history of major adverse cardiac events, 63.4% vs. 41.6% for hypertension). U-COPD patients showed higher all-cause mortality (11.8%) versus G-COPD (8.8%) and non-COPD (1.5%) patients, with SMRs of 1.24 (95%CI: 1.21-1.27) and 2.96 (95%CI: 2.89-3.03), respectively. COPD-related mortality was higher among U-COPD (4.8%) versus G-COPD (2.6%) patients with an SMR of 1.70 (95%CI: 1.63-1.76). Exacerbations occurrence was higher in U-COPD (96.1%) versus G-COPD (43.3%) patients, with SMR of 2.20 (95%CI: 2.19-2.22).
CONCLUSIONS: Patients with U-COPD showed higher all-cause and COPD-related mortality than those with G-COPD and non-COPD, emphasising the need for improved management strategies. The lack of information on potential confounding factors, including eosinophil data and smoking status, may affect the study findings.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
RWD167
Topic
Real World Data & Information Systems, Study Approaches
Topic Subcategory
Health & Insurance Records Systems
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)