Lower 30-day readmission rates with roflumilast treatment among patients hospitalized for chronic obstructive pulmonary disease

Abstract

Alex Z Fu,1 Shawn X Sun,2 Xingyue Huang,2 Alpesh N Amin31Georgetown University Medical Center, Washington, DC, 2Health Economics and Outcomes Research, Forest Laboratories, LLC, an affiliate of Actavis, Inc., Jersey City, NJ, 3Department of Medicine, University of California, Irvine, CA, USABackground: Few data exist related to the impact of roflumilast on health care utilization. This retrospective study estimated 30-day hospital readmission rates between patients who did and did not use roflumilast among those with COPD hospitalizations.Methods: Data were from MarketScan, a large US commercial health insurance claims database. Patients aged ≥40 years with at least one hospitalization for COPD between 2010 and 2011 were included. The roflumilast group included patients who used roflumilast within 14 days after the first hospitalization (index), while the comparison group (non-roflumilast) included patients who did not use roflumilast during the study period. Continuous enrollment for at least 6 months before and 30 days after the index date was required. The 30-day hospitalization rate was calculated after the index hospitalization. Conditional logistic regression with propensity score 1:3 matching was employed to assess the difference in 30-day hospital readmission rates between the roflumilast and non-roflumilast groups, adjusting for baseline characteristics, comorbidity, health care utilization, and COPD medication use within 14 days after the index date.Results: A total of 15,755 COPD patients met the selection criteria, ie, 366 (2.3%) in the roflumilast group and 15,389 (97.7%) in the non-roflumilast group. The mean (± standard deviation) age was 71±12.5 years and 52% were female. After propensity score matching, all-cause 30-day hospitalization rates were 6.9% and 11.1% in the roflumilast and non-roflumilast groups, respectively. COPD-related 30-day hospitalization rates were 6.3% and 9.2% in the roflumilast and non-roflumilast groups, respectively. Conditional logistic regression identified a significantly lower likelihood of all-cause 30-day readmission (odds ratio 0.59, 95% confidence interval 0.37–0.93, P=0.023) for roflumilast patients relative to non-roflumilast patients.Conclusion: This study showed, in a real-world setting, that use of roflumilast was associated with a lower rate of hospital readmission within 30 days among patients hospitalized for COPD.Keywords: chronic obstructive pulmonary disease, roflumilast, health care utilization, hospital readmission