Open AccessImpact of changes to reimbursement of fixed combinations of inhaled corticosteroids and long‐acting β 2 ‐agonists in obstructive lung diseases: a population‐based, observational study
Author(s) -
Björnsdóttir U. S.,
Sigurðardóttir S. T.,
Jonsson J. S.,
Jonsson M.,
Telg G.,
Thuresson M.,
Naya I.,
Gizurarson S.
Publication year - 2014
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.12473
Subject(s) - medicine , reimbursement , asthma , copd , observational study , obstructive lung disease , population , corticosteroid , health care , pediatrics , physical therapy , environmental health , economics , economic growth
Summary Background In 2010, the Icelandic government introduced a new cost‐saving policy that limited reimbursement of fixed inhaled corticosteroid/long‐acting β 2 ‐agonist ( ICS / LABA ) combinations. Methods This population‐based, retrospective, observational study assessed the effects of this policy change by linking specialist/primary care medical records with data from the Icelandic Pharmaceutical Database. The policy change took effect on 1 January 2010 (index date); data for the year preceding and following this date were analysed in 8241 patients with controlled/partly controlled asthma and/or chronic obstructive pulmonary disease ( COPD ) who had been dispensed an ICS / LABA during 2009. Oral corticosteroid ( OCS ) and short‐acting β 2 ‐agonist ( SABA ) use, and healthcare visits, were assessed pre‐ and post‐index. Results The ICS/LABA reimbursement policy change led to 47.8% fewer fixed ICS/LABA combinations being dispensed during the post‐index period among patients whose asthma and/or COPD was controlled/partly controlled during the pre‐index period. Fewer ICS monocomponents were also dispensed. A total of 48.6% of patients were no longer receiving any respiratory medications after the policy change. This was associated with reduced disease control, as demonstrated by more healthcare visits (44.0%), and more OCS (76.3%) and SABA (51.2%) dispensations. Conclusions Overall, these findings demonstrate that changes in healthcare policy and medication reimbursement can directly impact medication use and, consequently, clinical outcomes and should, therefore, be made cautiously.