The Burden of COPD

The economic burden of COPD is substantial and rising1

See the data  >

Long-acting bronchodilators prior to patient discharge

See the data  >

The economic burden of COPD is substantial and rising1

See the data  >

Long-acting bronchodilators prior to patient discharge

See the data  >


Unlike other chronic conditions, hospitalization rates for COPD have not declined in recent years2

 

In the next decade, the economic impact of COPD is projected to increase more than 50%1

The average annual number of hospital discharges for COPD was 100,000 higher from 2008 to 2012 than from 2001 to 20072


COPD is one of the top 5 causes of hospital readmissions among Medicare patients3,4*

The all-cause 30-day readmission rate for COPD is approximately 21%5

*According to the Centers for Medicare & Medicaid Services (CMS) Hospital Readmissions Reduction Program. 


A comprehensive COPD treatment strategy program includes discharge planning6,7

  • Strategies to improve clinical outcomes include a comprehensive COPD treatment program that aligns with clinical guidelines
  • According to GOLD, prior to discharge, patients should start long-acting bronchodilators, either beta2-agonists and/or anticholinergics with or without inhaled corticosteroids8 
  • COPD treatment now focuses on an overall strategy to improve care through coordination, patient engagement, and discharge planning6,7 

of Medicare patients with COPD are discharged on long-acting bronchodilators9  


References:
1.
Ford ES, Murphy LB, Khavjou O, Giles WH, Holt JB, Croft JB. Total and state-specific medical and absenteeism costs of COPD among adults aged ≥ 18 years in the United States for 2010 and projections through 2020. Chest. 2015;147(1):31-45.
2. Ford ES. Hospital discharges, readmissions, and emergency department visits for chronic obstructive pulmonary disease or bronchiectasis among US adults: findings from the Nationwide Inpatient Sample 2001-2012 and Nationwide Emergency Department Sample 2006-2011. Chest. 2015;147(4):989-998.
3. Centers for Medicare & Medicaid Services. Readmissions reduction program. http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Readmissions-Reduction-Program.html. Accessed February 10, 2016.
4. The Advisory Board Company. AHRQ: the conditions that cause the most readmissions. https://www.advisory.com/daily-briefing/2014/04/22/most-common-readmissions. Accessed February 10, 2016.
5. US Department of Health and Human Services. Agency for Healthcare Research and Quality. Welcome to HCUPnet. http://hcupnet.ahrq.gov. Accessed February 10, 2016.
6. National Committee for Quality Assurance. Insights for Improvement: Advancing COPD Care Through Quality Measurement. 2009. http://www.ncqa.org/portals/0/publications/NCQA_Insights_Improvement_FINAL.pdf. Accessed February 10, 2016.
7. National Quality Forum. MAP Pre-rulemaking Report: 2013 Recommendations on Measures Under Consideration by HHS. February 2013. https://www.qualityforum.org/publications/2013/02/map_pre-rulemaking_report_-_february_2013.aspx. Accessed February 10, 2016.
8. Global strategy for the diagnosis, management and prevention of COPD. Global Initiative for Chronic Obstructive Lung Disease (GOLD). 2016: 1-80.
9. Yip NH, Yuen G, Lazar EJ, et al. Analysis of hospitalizations for COPD exacerbation: opportunities for improving care. COPD: J Chron Obstruct Pulmon Dis. 2010;7:85-92.

Important Safety Information & Indication

WARNING: ASTHMA-RELATED DEATH

Long-acting beta2-adrenergic agonists (LABA) increase the risk of asthma-related death. Data from a large placebo-controlled US study that compared the safety of another long-acting beta2-adrenergic agonist (salmeterol) or placebo added to usual asthma therapy showed an increase in asthma-related deaths in patients receiving salmeterol. This finding with salmeterol is considered a class effect of LABA, including arformoterol, the active ingredient in BROVANA (see WARNINGS). The safety and efficacy of BROVANA in patients with asthma have not been established. All LABA, including BROVANA, are contraindicated in patients with asthma without use of a long-term asthma control medication (see CONTRAINDICATIONS).

BROVANA is not indicated for the treatment of acute episodes of bronchospasm, ie, rescue therapy, and does not replace fast-acting rescue inhalers. BROVANA should not be initiated in patients with acutely deteriorating COPD, which may be a life-threatening condition. 

BROVANA should not be used in conjunction with other inhaled, long-acting beta2-agonists. BROVANA should not be used with other medications containing long-acting beta2-agonists. Patients who have been taking inhaled short-acting beta2-agonists on a regular basis should be instructed to discontinue their regular use and to use them only for symptomatic relief for acute respiratory symptoms.

All LABA, including BROVANA, are contraindicated in patients with asthma without use of a long-term asthma control medication.

As with other inhaled beta2-agonists, BROVANA can produce paradoxical bronchospasm that may be life-threatening. If paradoxical bronchospasm occurs, BROVANA should be discontinued immediately and alternative therapy instituted.

BROVANA, like other beta2-agonists, can produce a clinically significant cardiovascular effect in some patients as measured by increases in pulse rate, blood pressure, and/or symptoms.

BROVANA should be used with caution in patients with cardiovascular disorders, especially coronary insufficiency, cardiac arrhythmias, and hypertension; in patients with convulsive disorders or thyrotoxicosis; and in patients who are unusually responsive to sympathomimetic amines.

BROVANA, as with other beta2-agonists, should be administered with extreme caution to patients being treated with monoamine oxidase inhibitors, tricyclic antidepressants, or drugs known to prolong the QTc interval because the action of adrenergic agonists on the cardiovascular system may be potentiated by these agents.

Overall efficacy of BROVANA was maintained throughout the 12-week trial duration. Some tolerance to the bronchodilator effect of BROVANA was observed after 6 weeks of dosing (at the end of the dosing interval), although the FEV1 improvement remained statistically significant. This was not accompanied by other clinical manifestations of tolerance.

The five most common adverse events reported with frequency ≥2% in patients taking BROVANA, and occurring more frequently than in patients taking placebo, were pain (8% vs 5%), chest pain (7% vs 6%), back pain (6% vs 2%), diarrhea (6% vs 4%), and sinusitis (5% vs 4%).

For additional information, please see the full Prescribing Information including Boxed Warning, and Medication Guide for BROVANA (arformoterol tartrate) Inhalation Solution, at www.sunovionprofile.com/brovana.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Indication
BROVANA® (arformoterol tartrate) Inhalation Solution is indicated for the long-term, twice-daily (morning and evening) maintenance treatment of bronchoconstriction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. BROVANA is for use by nebulization only.