For the estimated 9 million patients diagnosed with chronic obstructive pulmonary disease (COPD) in the United States, there are multiple prescription therapies that are available for treating the associated symptoms. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) treatment guidelines recommend a step-up treatment paradigm that begins with short-acting agents (short-acting beta2 agonists [SABAs], short-acting muscarinic antagonists [SAMAs], or SABA/SAMA combinations) for use as needed (i.e., rescue therapy) in patients with mild COPD. Patients with moderate disease should also receive a long-acting bronchodilator (usually the long-acting muscarinic antagonist [LAMA] tiotropium [Boehringer Ingelheim’s Spiriva]); physicians could add a second long-acting bronchodilator (e.g., a long-acting beta2 agonist [LABA], or switch to a LABA/LAMA or LABA/inhaled corticosteroid [ICS]) if symptoms persist. Patients with severe or very severe COPD receive combination therapy with a short-acting bronchodilator to use as needed and long-acting bronchodilators in combination with an ICS (e.g., LABA/ICS plus LAMA).
Using national patient-level claims data, this report analyzes physician adherence to the treatment guidelines by exploring the use of key therapies in the newly diagnosed and recently treated COPD patient populations. Considering newly diagnosed patients, the report provides a quantitative analysis of treatment patterns and share by line of therapy, as well as progression between lines, duration of treatment on each line, and use of concomitant treatment. With respect to recently treated patients, the report quantifies a drug’s source of business compared with its competitors and details which drugs precede others through an analysis of add-versus-switch patterns. Additional analyses explore persistency and compliance by brand.