Healthcare resource utilization and exacerbations in patients with chronic obstructive pulmonary disease treated with nebulized glycopyrrolate in the USA: a real-world data analysis.

Aims: This study compared medication use, healthcare resource utilization (HRU), and exacerbations among individuals with chronic obstructive pulmonary disease (COPD) who initiated glycopyrrolate/eFlow Closed System nebulizer 25 mcg/mL glycopyrrolate (hereafter GLY) in a real-world setting before and after treatment initiation.

Materials And Methods: Retrospective claims and hospital charge master data were used to identify individuals ≥ 40 years of age diagnosed with COPD who initiated GLY between 1 April 2018 and 28 February 2019 (first prescription claim = index date). Patients were excluded if they had ≥1 asthma diagnosis in the 6-month pre-index period. The proportion of patients with COPD-related medications, other outpatient HRU, hospitalizations, and exacerbations were compared between the 6-month pre-index and 6-month follow-up periods. Among patients utilizing the service, per-person utilization rates were compared between the two periods.

Results: Among patients initiating GLY ( = 767), the mean age was 71.4 years, 56.1% were female, and the mean Charlson Comorbidity Index score was 2.0. The mean number of GLY claims per person was 3.8 during the follow-up period. Compared to the pre-index period, a lower proportion of patients had claims for COPD medications including oral corticosteroids (62.1% vs. 69.1%,  = .0001) and fixed-dose SAMA/SABA (26.1% vs. 33.0%,  < .0001) and a higher proportion of patients had claims for LABA (29.7% vs. 22.6%,  < .0001) during the follow-up period. Fewer patients had ≥1 COPD-related physician office visit (42.4% vs. 49.8%,  < .0001), radiology test (40.7% vs. 46.5%,  = .005), or moderate exacerbation (48.0% vs. 53.2%,  = .01) after initiating GLY. Among patients with linkage to inpatient data ( = 316), fewer were hospitalized (7.9% vs. 13.0%,  = .037) and hospital length of stay was shorter (1.9 vs. 3.6 days,  = .017) after initiating GLY/eFlow.

Conclusions: Among patients initiating GLY in a real-world setting, COPD medications, hospitalizations, other HRU, and exacerbations decreased after treatment initiation compared with the 6-month pre-index period.