A105-07 Racial/Ethnic Disparities in COPD-related Healthcare Resource Utilization and Expenditures Following Triple Therapy Initiation: Results From the US Duality Disparities Study

Abstract Rationale While the 2025 Global Initiative for Chronic Obstructive Lung Disease (GOLD) Report recommended inhaled triple therapy for patients with advanced COPD who exacerbate despite treatment with LAMA/LABA, limited evidence exists on disparities in healthcare resource utilization (HCRU) and expenditures following treatment initiation. This study aimed to describe COPD-related HCRU and expenditures following triple therapy initiation and differences by race/ethnicity. Methods This observational, retrospective database analysis utilized the 100% Medicare Fee-for-Service (FFS) and Inovalon MORE2 Registry of closed claims. Eligible patients (age ≥40 years) were required to present ≥1 claim with COPD diagnosis between 1/1/2022 and 12/31/2022 (FFS) or 12/31/2023 (MORE2), ≥1 severe or ≥ 2 moderate COPD exacerbations, initiation of either single or multiple device-delivered inhaler triple therapy within 12-months after earliest exacerbation (initiation set as index date), and 12 months of continuous enrollment preceding and following index. COPD-related HCRU and expenditures were assessed during the 12-month post-index period and were identified by claims with an ICD-10-CM diagnosis code for COPD. Differences by race/ethnicity subgroups were assessed with chi-square tests of equality of proportions and non-parametric Kruskal Wallis tests. Results A total of 23, 445 patients initiating triple therapy following COPD exacerbation (s) qualified for analysis. Overall, patients presented an annual mean (SD) of 6. 4 (5. 0) COPD-related physician outpatient visits, 1. 2 (3. 1) emergency department (ED) visits, and 0. 2 (0. 5) hospitalizations; with 40. 0% of patients presenting an ED visit and 11. 0% presenting a hospitalization, while 25. 6% of patients had a pulmonologist visit. Compared to White patients, Black/African American patients presented significantly lower rates of pulmonologist visits (15. 6% vs. 31. 0%) and higher rates of ED visits (50. 6% vs. 39. 6%) and hospitalizations (16. 0% vs. 10. 8%; p’s0. 0001). Regarding healthcare expenditures, the overall sample incurred mean (SD) annual COPD-related healthcare costs of 14, 835 (17, 519). Compared to White patients, Black/African American patients incurred significantly greater COPD-related hospital costs (2, 570 vs. 1, 519) and overall COPD-related healthcare costs (17, 439 vs. 14, 918), while Asian patients presented significantly lower hospital costs (1, 104) and overall COPD-related costs (12, 894, p’s0. 0001). Of those who had an ED visit, Black/African American patients incurred higher COPD-related ED costs (4, 013) than White (2, 879) or Asian (3, 046) patients (p 0. 0001). Conclusions Across racial groups, COPD-related HCRU and costs remained high over the year after initiating triple therapy. Findings highlight persistent disparities in COPD management, care access, and outcomes by race/ethnicity, underscoring the need for targeted preventative interventions to reduce the progression to exacerbation. This abstract is funded by: AstraZeneca