PROAIR(Albuterol) is associated with Lower Hospital Readmission Rates for Chronic Obstructive Pulmonary Disease (COPD) Patients based on Real World Evidence Study of Medicare Claims Data

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In PROAIR, Pulmonary

Background:

Chronic Obstructive Pulmonary Disease (COPD) is frequently associated with hospital readmission. Readmission is a hospital quality measure that reflects dimensions of quality of inpatient care and also impacts overall programs by payers such as CMS’s Star Rating Program, HRRP and Value-Based Purchasing. PROAIR(Albuterol) Inhaled beta-2-agonist. Studies have shown that PROAIR(Albuterol) delivers a warmer, lower-impact, and longer-lasting plume compared to its competitors. Dexur’s analysis of Real-World Evidence based on Medicare Claims data showed that the use of PROAIR(Albuterol)within 7 days of hospitalization was associated with lower hospital readmission rates for Chronic Obstructive Pulmonary Disease (COPD) Patients. Reduction in readmission rates helps hospitals improve their outcomes for various cost and quality programs. Dexur is an approved entity to perform Medicare claims data analysis, which it uses to perform quality outcomes analysis. Dexur has published several papers with Harvard Medical School on quality outcomes related topics. Dexur’s analysis of Drugs and their impact on quality outcomes, such as readmissions and mortality, are used by Hospitals, IDNs, and ACOs to implement best practices and manage Real World Evidence based risk factors.

Methods:

We conducted a retrospective study using Dexur’s analysis of Real-World Evidence from Medicare Claims data, for hospitalizations between January 2019 to September 2019. Our methodology criteria was as follows:

1. Inclusion Criteria: Selected Medical Hospitalizations with Primary Diagnosis with Chronic Obstructive Pulmonary Disease (COPD) codes (Listed in table below)

2. Stratified Selected population into cohorts

   • Chronic Obstructive Pulmonary Disease (COPD) patients who dispensed PROAIR(Albuterol) (Fluticasone furoate/Vilanterol) within 7 Days of Hospitalization using Part D drugs claims database

   • Chronic Obstructive Pulmonary Disease (COPD) patients who did not dispense PROAIR(Albuterol) within 7 Days of Hospitalization

3. 30 Day readmission rates were analyzed for both population cohorts

Results:

Overall, PROAIR(Albuterol) was associated with lower hospital readmission rates for all Primary ICD Diagnosis Codes examined. For patients whose primary ICD Diagnosis was “Chronic obstructive pulmonary disease with (acute) exacerbation” (J441) and when PROAIR(Albuterol) was used within 7 days of hospitalization, the readmission rate was 20.99% compared to the cohort where PROAIR(Albuterol) was not used, whose readmission rate was 24.12%. The readmission odds ratio for these cohorts was 0.84. The use of PROAIR(Albuterol) was associated with a 16% lower readmission rate when used within 7 days of hospitalization. The full list of studied ICD codes, readmission rates, odds ratios, confidence intervals, and percentage reduction in readmission with PROAIR(Albuterol) is shown below.

Primary ICD Diagnosis Code	Primary ICD Diagnosis Code Description	Total Hospitalizations without PROAIR	Readmission without PROAIR	Readmission Rate without PROAIR	Total Hospitalizations with PROAIR	Readmission with PROAIR	Readmission Rate with PROAIR	Readmission Odds Ratio	Reduction in Readmission with PROAIR (%)	Confidence Interval (-)	Confidence Interval (+)
J441	Chronic obstructive pulmonary disease with (acute) exacerbation	144,905

Dexur also leveraged Medicare claims data to understand what percentage of patients hospitalized with Pneumonia at major Hospitals were not prescribed PROAIR(Albuterol) within 7 days of discharge.

ICD CODE	Hospital	Hospitalizations with COPD	% of Hospitalizations without PROAIR
J441	Lehigh Valley Hospital - Cedar Crest, ALLENTOWN, PA, 18103	333	97.00%
	Enloe Medical Center, CHICO, CA, 95926	332	96.99%
	AdventHealth Orlando, ORLANDO, FL, 32803	324	96.91%

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Conclusions:

According to analysis of Real-World Evidence of Medicare Claims data, for hospitalizations between January 2019 to September 2019, the use of PROAIR(Albuterol) within 7 days of hospitalization can lead to substantial reductions in hospital readmission rates of Chronic Obstructive Pulmonary Disease (COPD) patients.