Among the leading cause of death in US, Chronic lower respiratory diseases ranks number 3 after heart disease and cancer with 149,205 deaths in 2013. As per the CDC data available from 2012, there are 18.7 million adults and 6.8 million children suffering from Asthma. In 2013, the number of patients diagnosed with Chronic Obstructive Pulmonary Disease (COPD) was 6.8 million.
Reimbursement of COPD treatment
In October 2014, the Centres for Medicare and Medicaid Services (CMS) expanded its Hospital Readmission Reduction Program (HRRP) and included chronic obstructive pulmonary disease (COPD) in the list. COPD is the third most frequent reason for patient’s readmission to hospitals in a time duration of 30 days. The readmission penalties are targeted towards encouraging hospitals to improve discharge planning and follow-up care. Starting October 2015, the Medicare reimbursement would be reduced for acute care hospitals whose COPD readmission rates exceed set thresholds.
Estimates suggest that more than 22% of people hospitalized with COPD flare-ups are readmitted within a month of discharge. In 2012, the exacerbation related costs accounted for nearly 70% of the estimated $50 billion in annual COPD health expenditures, placing COPD related readmission expenses at the third highest among Medicare beneficiaries.
Trends affecting uptake of new treatments
The impending expiration of the U.S. patent on the unique delivery system, the purple Advair Diskus, in 2016 is expected to be a game changer with generics expected to capture a significant market share and also lead to a reduction in price. This looming generic threat has forced GSK to slash prices of the block-buster drug by half earlier this month, with US sales expected to drop to $469 million by 2020, from $3.13 billion last year. Patients suffering from COPD and asthma tend to prefer a once-daily treatment and combination drugs have proven to be more effective. Approved in May 2015, GSK’s Breo Ellipta is the first once-daily combination of the inhaled corticosteroid (ICS) and the long-acting beta2-agonist (LABA) vilanterol (VI), for adults suffering from asthma in the US.