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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.

international journal of clinical practice

Impact 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