OBJECTIVES

: Adherence to COPD therapies and impact on healthcare use is poorly documented in France. Our objective was to describe persistence in newly treated COPD patients in France, and to assess a potential impact of non-persistence on costs related to healthcare use.

METHODS

: All patients aged 45 and over, having at least one delivery of bronchodilator over 3 consecutive quarters between 2007 and 2014, and without asthma markers, were selected in the Echantillon Généraliste des Bénéficiaires (EGB). It is a 1/97^e random sample of the French claims database which collects details of healthcare reimbursed, for each beneficiary. Persistence was measured at 12 months in newly treated patients and assessed by non-interruption of deliveries during at least 90 days. Healthcare-related costs were compared between persistent and non-persistent patients, after matching and adjustment for available confounding factors.

RESULTS

: In 721 persistent patients to new therapy for COPD and 721 non-persistent patients, numbers of COPD therapies and visits to healthcare professionals were similar. However, medical procedures were less frequent in non-persistent patients than in persistent patients, especially pulmonary function testing, X-rays and chest scan. The total annual health care cost was higher for persistent than for non-persistent patients (€3,677 vs. €3,460), due to higher drug costs (€542 vs. €178). Hospitalisation costs were similar in both groups (€2,138 for persistent patients vs. €2,181 for non-persistent patients).

CONCLUSIONS

: In this population of mild to moderate COPD patients, no difference on health care costs was observed between persistent and non-persistent patients. It can be explained by the similar numbers of exacerbations in both groups and, as is always the case with observational data, residual confounding factors could explain part of the results (e.g. disease severity).