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
Barjaktarevic et al. (Fri,) studied this question.
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