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The Impact of Treatment Change on Economic and Quality of Life Outcomes Among Treated, Adherent, Uncontrolled Patients with Persistent Asthma
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A4829 - The Impact of Treatment Change on Economic and Quality of Life Outcomes Among Treated, Adherent, Uncontrolled Patients with Persistent Asthma
Author Block: N. Lugogo1, S. Gabriel2, C. M. Carpinella3, R. Ariely2, L. K. Lee3, G. Mosnaim4; 1Department of Medicine, University of Michigan, Ann Arbor, MI, United States, 2Teva Pharmaceuticals, Malvern, PA, United States, 3Health Outcomes Practice, Kantar Health, San Mateo, CA, United States, 4NorthShore University HealthSystem, Evanston, IL, United States.
Rationale: The burden of non-adherent asthma patients is well documented, but a research gap exists regarding the unmet needs of adherent patients, particularly those who have been on multiple treatments. The current study compared quality of life and economic outcomes as a function of treatment change among uncontrolled, treated, adherent patients with persistent asthma. Methods: Data from the 2015 and 2016 US National Health and Wellness Survey were used to identify self-reported adherent asthma patients with uncontrolled persistent asthma (self-reported while on medication) who changed treatment or did not change treatment. Outcomes included health-related quality of life (HRQoL) (SF-36v2), Work Productivity and Activity Impairment (WPAI-GH), healthcare resource utilization (HCRU), and estimated annual indirect and direct costs. Generalized linear models were used to examine whether outcomes differed between groups. Results: Of 645 patients analyzed, 274 (42%) changed treatment. No significant differences in outcomes experienced by patients who changed treatment versus those who did not were observed for work productivity impairment (43% versus 39%) or activity impairment (54% versus 51%). Moreover, patients who changed treatment had more healthcare provider visits (adjusted mean=8.8 vs. 7.1, p=.01) and higher total costs (adjusted mean=$37,587 vs. $30,139, p=.04) yet lower physical HRQoL (adjusted mean=38.3 vs. 39.9, p=.05) versus those without a change. Conclusions: These findings suggest that many adherent patients with uncontrolled persistent asthma who change treatment have higher healthcare costs and slightly reduced physical HRQoL, indicating that treatment change may negatively impact healthcare budgets. Improved understanding of the factors that influence treatment change outcomes could aid clinical decision making, and support efforts to improve disease control and optimize healthcare budgets.
Author Block: N. Lugogo1, S. Gabriel2, C. M. Carpinella3, R. Ariely2, L. K. Lee3, G. Mosnaim4; 1Department of Medicine, University of Michigan, Ann Arbor, MI, United States, 2Teva Pharmaceuticals, Malvern, PA, United States, 3Health Outcomes Practice, Kantar Health, San Mateo, CA, United States, 4NorthShore University HealthSystem, Evanston, IL, United States.
Rationale: The burden of non-adherent asthma patients is well documented, but a research gap exists regarding the unmet needs of adherent patients, particularly those who have been on multiple treatments. The current study compared quality of life and economic outcomes as a function of treatment change among uncontrolled, treated, adherent patients with persistent asthma. Methods: Data from the 2015 and 2016 US National Health and Wellness Survey were used to identify self-reported adherent asthma patients with uncontrolled persistent asthma (self-reported while on medication) who changed treatment or did not change treatment. Outcomes included health-related quality of life (HRQoL) (SF-36v2), Work Productivity and Activity Impairment (WPAI-GH), healthcare resource utilization (HCRU), and estimated annual indirect and direct costs. Generalized linear models were used to examine whether outcomes differed between groups. Results: Of 645 patients analyzed, 274 (42%) changed treatment. No significant differences in outcomes experienced by patients who changed treatment versus those who did not were observed for work productivity impairment (43% versus 39%) or activity impairment (54% versus 51%). Moreover, patients who changed treatment had more healthcare provider visits (adjusted mean=8.8 vs. 7.1, p=.01) and higher total costs (adjusted mean=$37,587 vs. $30,139, p=.04) yet lower physical HRQoL (adjusted mean=38.3 vs. 39.9, p=.05) versus those without a change. Conclusions: These findings suggest that many adherent patients with uncontrolled persistent asthma who change treatment have higher healthcare costs and slightly reduced physical HRQoL, indicating that treatment change may negatively impact healthcare budgets. Improved understanding of the factors that influence treatment change outcomes could aid clinical decision making, and support efforts to improve disease control and optimize healthcare budgets.
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