Disruption of the refill of patients' regular combination inhaled corticosteroid therapy brand may have impacted symptoms and disease control and potentially lead to an increased rate of costly exacerbations and hospitalizations.
A retrospective pharmacy analysis was conducted on 44,832 patients from age 12 and older who had Medicare Part D coverage in 2016 and 2017 and received budesonide/formoterol fixed dose combination (BUD/FORM FDC) as their inhaled corticosteroid (ICS) and a long-acting beta-agonist (LABA) medication in 2016. Each of these patients were followed through Dec. 31, 2017, to observe ICS/LABA switches, changes in controller medications and use of acute medications like oral corticosteroids, antibiotics and rescue inhalers.
About half (49 percent) of patients within the study attempted to fill a BUD/FORM FDC prescription at a pharmacy after the formulary block on Jan. 1, 2017. Of the patients who attempted to fill the respiratory medication, only 46 percent were approved for more than one refill of BUD/FORM FDC, and 52 percent had their refill rejected. Of the patients who were rejected a refill, 37 percent switched to another ICS/LABA fixed dose combination, 27 percent of stopped their controller medication, 10 percent received monotherapy, 10 percent received triple therapy and 16 percent received other controller combinations. Of the patients who did not switch to an alternate controller medication, 37 percent filled a prescription for an acute medication. Overall, a third of the 44,832 patients did fill any controller medication post-block, 12 percent switched to monotherapy and 17 percent had no inhaled medication fills.
"This Medicare Part D formulary switch was associated with a disruption in the management of patients' respiratory conditions," says Dr. Katie Devane, lead researcher. "Approximately 45 percent of the patients did not receive an ICS/LABA after the formulary block, which may have impacted patients' symptoms and disease control and potentially lead to an increased rate of costly exacerbations and hospitalizations."
Further results from these two studies will be shared at CHEST Annual Meeting 2018 in San Antonio on Monday, Oct. 8, 2:15 p.m. to 2:30 p.m., at the Henry B. Gonzalez Convention Centre, Room 207A. The study abstracts can be viewed on the journal CHEST® website.
ABOUT CHEST 2018
CHEST 2018 is the 84th annual meeting for the American College of Chest Physicians held Oct. 6 to Oct. 10, 2018, in San Antonio, Texas. The American College of Chest Physicians, publisher of the journal CHEST®, is the global leader in advancing best patient outcomes through innovative chest medicine education, clinical research and team-based care. Its mission is to champion the prevention, diagnosis and treatment of chest diseases through education, communication and research. It serves as an essential connection to clinical knowledge and resources for its 19,000 members from around the world who provide patient care in pulmonary, critical care and sleep medicine. For more information about CHEST 2018, visit chestmeeting.chestnet.org, or follow CHEST meeting hashtag, #CHEST2018, on social media.