Roflumilast Associated with COPD Cost and Healthcare Utilization

Tampa—Exacerbation is the leading cause of hospitalization and death in patients with chronic obstructive pulmonary disease (COPD). In 2010, COPD-related annual total cost was estimated at $49.9 billion. Approximately $29.5 billion of the COPD-related cost was associated with direct healthcare costs, with hospital care representing the largest share of cost. Roflumilast is the first phosphdiesterade-4 inhibitor approved to decrease risk of exacerbations in patients with severe COPD correlated with chronic bronchitis and a history of exacerbations.

Rahul Jain and colleagues presented the results of this study at the AMCP meeting during a poster session titled Impact of Roflumilast Treatment on Healthcare Utilizations and Costs Among COPD Patients in a Managed Care Population.

In the study, a cohort of 328 patients who had at least 1 pharmacy claim for roflumilast were compared with a cohort of 328 patients who had no pharmacy claim for roflumilast but had at least 2 pharmacy claims to a different COPD medication. Demographics and baseline clinical conditions were not significantly different in the roflumilast patient cohort compared to the patients not receiving roflumilast; however, in the roflumilast cohort, 41.2% had a diagnosis of asthma and 32.3% of the patients not receiving roflumilast had an asthma diagnosis (P=.01).

The roflumilast patient cohort experienced significantly higher all-cause pharmacy costs compared to the patients not receiving roflumilast ($702±$464 vs $608±$646; P<.05). Statistically insignificant but numerically lower medical costs were identified for the roflumilast patient cohort compared to the patients not receiving roflumilast ($1980±$3994 vs $2193±$4142; P=.41).

The roflumilast patient cohort exhibited statistically insignificant but numerically lower total cost, which includes medical costs plus pharmacy costs ($2682±$4061 vs $2802±$4229; P=.09). The roflumilast patient cohort also demonstrated statistically insignificant but numerically lower all-cause inpatient hospitalizations (.07±.15 vs .09±.18; P=.1057), as well as statistically insignificant but numerically lower all-cause outpatient visits (2.74±2.12 vs 3.03±2.73; P=.1291).

Compared to the patients not receiving roflumilast, the roflumilast group had significantly lower hospitalization rates (P=.649) and lower total healthcare costs (P=.357).

The results suggest that the roflumilast cohort may have lower total healthcare costs and lower resource utilization compared to the patients not receiving roflumilast, despite increased pharmacy costs for the roflumilast cohort.  

The study’s authors noted some limitations. The results of the study are only relevant to a short follow-up time. All patients were commercially insured, excluding individuals who are insured through public health programs or those who are uninsured; therefore, the results may not be generalizable to the large public.

This study was supported by Forest Laboratories, Inc., New York, NY, USA.