OBJECTIVES : To describe healthcare resource utilisation (HCRU) and direct medical costs in COPD patients initiating LAMA/LABA therapy in a general practice (GP) cohort from England.

METHODS : A retrospective cohort study using linked primary and secondary healthcare data from the Clinical Practice Research Datalink Aurum and Hospital Episode Statistics datasets, indexed COPD patients on their first prescription of a fixed-dose LAMA/LABA therapy (Jun-2015 to Dec-2018). COPD-related HCRU (GP, outpatient, accident & emergency [A&E] visits, inpatient stays) and direct medical costs were assessed in the 12 months pre- (baseline) and post- (follow-up) index date by treatment.

RESULTS : 10,991 incident LAMA/LABA users were identified (2,344 indexed on aclidinium/formoterol [ACL/FF]; 1,999 indacaterol/glycopyrronium [IND/GLY]; 1,333 tiotropium/olodaterol [TIO/OLO]; 5,315 umeclidinium/vilanterol [UMEC/VI]) with similar baseline characteristics across index treatments. Approximately 65% of patients across index treatments had a GP consultation in baseline compared with >90% during follow-up. Frequency of outpatient visits pre- (13.0-19.7%) and post-index (14.0-20.3%) were similar. Patients indexed on UMEC/VI or ACL/FF experienced fewer outpatient visits (13.0-15.8%) than those on TIO/OLO or IND/GLY (17.0-20.3%). The inpatient stays in baseline ranged from 18.9% (ACL/FF) to 25.6% (IND/GLY), and from 25.2% (UMEC/VI) to 28.6% (TIO/OLO) during follow-up. Around 1% of all patients had A&E visits pre- and post-index, with no notable differences observed between index treatments. Across index treatments, inpatient stays accounted for the greatest costs in resource users (£3333/£3659 pre-/post-index, respectively), followed by outpatient visits (£363/£400), A&E visits (£191/£238), prescription medications (£121/£78), and lastly GP consultations (£78/£99). Mean total COPD-related costs per-patient during follow-up (£1067) were similar to those at baseline (£901).

CONCLUSIONS : COPD-related HCRU was similar across index treatments. Inpatient stays accounted for the greatest costs of all healthcare components for resource users. Overall costs did not increase substantially over time for patients receiving fixed-dose LAMA/LABA treatment in England.

Funding: GSK (study 214731)