Presentation (CTI)

OBJECTIVES: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and contributes to significant healthcare utilisation in Ireland. Pharmacological management is guided by national and international recommendations; the aim of this study is to describe the utilisation of long-acting muscarinic antagonists (LAMA), long-acting β₂-agonists (LABA), LABA/LAMA combination therapies, and LABA/LAMA/inhaled corticosteroid (ICS) triple therapies in Ireland.
METHODS: This was a repeated cross-sectional study based on paid pharmacy claims data in the community setting in Ireland. Data were obtained from the Irish Community Drug Schemes (CDS) pharmacy claims database from the Health Service Executive Primary Care Reimbursement Services (HSE-PCRS). The CDS database contains basic demographic information and details on medicine claims coded using the WHO’s Anatomical Therapeutic Chemical (ATC) classification system for each individual with eligibility for the schemes. We restricted analyses to those aged ≥ 45 years.
RESULTS: In January 2021, there were almost 60,000 patients aged ≥ 45 years in receipt of long-acting inhaled therapies used in the maintenance treatment of COPD., increasing to almost 78,000 patients in December 2025. In January 2021, the majority of patients were receiving LAMA therapies (29,000 patients), followed by LABA/LAMA therapies (22,000 patients) and LABA/LAMA/ICS (9,000 patients). By December 2025, the majority of patients were in receipt of LABA/LABA/ICS (31,000 patients). LABA/LABA/ICS treatment accounted for the majority of expenditure on inhaled therapies used in the treatment of COPD in 2025; €22.3 million out of total expenditure of €45.8 million. In 2025, 54.35% of claims were for females. Across both females and males, the most common age group was 70-74 years.
CONCLUSIONS: Our study highlights the high prevalence of inhaled therapy use consistent with the management of COPD in this national cohort, as well as a shift in utilisation trends away from single or dual-therapy treatment to triple-therapy treatment.