Cost saving of switching to equivalent inhalers and its effect on health outcomes

Thorax
Chloe I BloomJennifer K Quint

Abstract

Switching inhalers to cheaper equivalent products is often advocated as a necessary cost saving measure, yet the impact on patient's health and healthcare utilisation has not been measured. We identified asthma and chronic obstructive pulmonary disease (COPD) patients from UK primary care electronic healthcare records between 2000 and 2016. A self-controlled case series was used to estimate incidence rate ratios (IRR); comparing outcome rates during the risk period, 3 months after the exposure (financially motivated switch), and control periods (preswitch and postrisk period). Four outcomes were assessed: disease exacerbation, general practitioner consultation, non-specific respiratory events and adverse-medication events. Medication possession ratio (MPR) was calculated to assess adherence. 2017 National Health Service indicative prices were used to estimate cost differences per equivalent dose. We identified a cohort of 569 901 asthma and 171 231 COPD regular inhaler users, 2% and 6% had been switched, respectively. Inhaler switches between a brand-to-generic inhaler, and all other switches (brand-to-brand, generic-to-generic, generic-to-brand), were associated with reduced exacerbations (brand-to-generic: IRR=0.75, 95% CI 0....Continue Reading

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Citations

Dec 28, 2019·Thorax·Anna Claire Murphy
May 29, 2020·The European Respiratory Journal·Lauri LehtimäkiTari Haahtela
Jun 6, 2020·Pharmaceutical Medicine·Alexander J K Wilkinson, Greg Anderson
Dec 18, 2020·Current Opinion in Pulmonary Medicine·Brian Allen, Loutfi S Aboussouan
Oct 15, 2020·Pulmonary Therapy·Alan Kaplan, Job F M van Boven
Jul 24, 2021·Breathe·Gráinne d'Ancona, John Weinman
Sep 29, 2021·Pulmonary Therapy·Federico LavoriniTari Haahtela

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