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Study Measures Real-World Comparative Effectiveness of Asthma Controller Medications
Date:7/8/2008

WellPoint's Health Outcomes Subsidiary HealthCore Finds Optimal Outcomes Can Be Achieved Through Compliant Use of Orally Administered Controllers

INDIANAPOLIS, July 8 /PRNewswire/ -- Compliance with inhaled medications for asthma can improve clinical outcomes, as measured by reduced emergency room visits and inpatient hospitalizations, according to a retrospective study conducted by HealthCore, Inc., the health outcomes research subsidiary of WellPoint, Inc. This study shows that the best outcomes were achieved by members who were compliant with inhaled corticosteroids, the National Asthma Education and Prevention Program (NAEPP) preferred therapy for patients with moderate to severe and severe asthma. However, the study identified that the majority of patients who took inhaled medications were less compliant than those taking oral medications, which may have led to less optimal clinical outcomes. HealthCore recently presented the study comparing the effectiveness of various asthma controller medications for patients at the American Thoracic Society's international conference in Toronto, Ontario.

Using administrative data and patient-reported outcomes, HealthCore evaluated the impact of the various therapeutic classes of controller medications used to treat persistent asthma. When taken in a compliant manner, the inhaled corticosteroids were shown to provide the highest value for the treatment of asthma. In the group of patients who were compliant with their inhaled corticosteroid regimen, the overall cost of care, emergency room utilization and inpatient hospitalizations were the lowest. In this analysis, patients in the oral asthma controller group were more likely to have inpatient and emergency room visits (OR=1.74; range: 1.02-2.99), and higher total health care costs ($235/yr). Study findings revealed that patient compliance with prescribed therapies is a critical part of successfully managing asthma, and that compliance was higher with members taking oral medications, particularly among children.

"While there is considerable controlled trial data on asthma controller medications, we sought to provide a more complete picture of how these therapies work for patients in their everyday lives," said Sam Nussbaum, M.D., WellPoint chief medical officer and executive vice president. "Evidence-based interventions in the treatment of asthma will benefit patients. Most significantly, real-world clinical research can help doctors decrease the negative impact of asthma on patients, allowing them to lead fuller, more productive lives."

According to a 2005 study on the burden of uncontrolled asthma, the illness takes a considerable economic toll on the U.S. health care system, costing an estimated $12.7 billion in 2002. Based on 2006 data, the U.S. Centers for Disease Control and Prevention estimates that 16.1 million adults and 6.8 million children in the U.S. currently have asthma. While consensus guidelines have been developed to optimally manage asthma, HealthCore's data provide real-world evidence on which of these therapies and combinations can offer the best outcomes and improve overall quality of life for patients with mild, moderate and severe persistent asthma.

HealthCore undertook this study based upon a recommendation from WellPoint's National Pharmacy and Therapeutics Committee, an independent body of physicians, clinicians, and pharmacists who advise WellPoint on its formulary decisions. To complete its study, HealthCore retrospectively analyzed the medical and pharmacy claims data of more than 55,000 patients from eight U.S. health plans who had used one of six types of asthma controller medications between 2003 and 2005. These data were integrated with quality of life surveys of more than 800 asthma patients from the same plans to evaluate potential differences in quality of life between the types of controller medications. The study was conducted in collaboration with a scientific steering committee consisting of individuals recommended by the American Academy of Family Physicians, the American Academy of Pediatrics and the American Association of Allergy and Immunology.

Study researchers found that among patients on a one-drug controller regimen, oral asthma controller medications offered better clinical outcomes for some members, attributable to improved patient compliance on these medications compared to inhaled asthma medications. When compliance with medication was not controlled, patients in the oral asthma controller group were less likely to have inpatient and emergency room visits (odds ratio (OR) =0.80; range: 0.72-0.88), and less likely to use .6 rescue medication inhalers (OR=0.81; range: 0.74-0.88) than those in the inhaled medication group.

Both oral and inhaled treatments offered comparable impact on patient-reported quality of life and productivity. Among patients taking more than one drug to control their asthma, researchers found that a combination of inhaled corticosteroids and long-acting beta-agonists was the best course of treatment in terms of improved outcomes and improved quality of life.

"HealthCore's data provided real-world evidence that patient compliance plays a major role in the overall effectiveness of asthma controller medications, with oral asthma controllers showing better compliance overall than asthma corticosteroid inhalants," said Brian Sweet, chief clinical pharmacy officer, WellPoint, Inc. "In the case of a chronically managed disease, like asthma, where a patient takes medication daily, HealthCore's ability to measure efficacy in the real world enables us to make more informed formulary decisions."

HealthCore, a subsidiary of WellPoint, is a health outcomes and clinical research organization that has served the needs of health plans, government agencies, physician practices and pharmaceutical manufacturers since 1996. HealthCore focuses on providing evidence of the real-world safety and effectiveness of therapeutics; offering insight to best utilize this evidence; and communicating these findings to health care decision-makers. The company's work is increasingly used to support evidence-based medicine, process improvement and patient-reported outcomes.

About WellPoint, Inc.

WellPoint, Inc. is the largest publicly traded commercial health benefits company in terms of membership in the United States. WellPoint, Inc. is an independent licensee of the Blue Cross Blue Shield Association and serves its members as the Blue Cross licensee for California; the Blue Cross and Blue Shield licensee for Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, New York (as Blue Cross Blue Shield in 10 New York City metropolitan counties and as Blue Cross, Blue Shield or Blue Cross Blue Shield in selected upstate counties only), Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), Wisconsin; and through UniCare. Additional information about WellPoint is available at http://www.wellpoint.com .


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SOURCE WellPoint, Inc.
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