Decision Resources, one of the world's leading research and advisory firms focusing on pharmaceutical and healthcare issues, finds that approximately half of pulmonologists and one quarter of primary care physicians (PCPs) believe that inhaled corticosteroids are overused for chronic obstructive pulmonary disease (COPD). However, half of specialists and three-quarters of PCPs say that inhaled corticosteroids have a role in the treatment of COPD.
According to the new PhysicianForum report entitled Chronic Obstructive Pulmonary Disease: Evolving Treatment and Reimbursement, a majority of PCPs believe that inhaled corticosteroids should be used in all levels of disease severity. By contrast, a majority of pulmonologists feel that inhaled corticosteroids should not be used in mild COPD.
"This disparity in PCP and pulmonologist opinion may be explained by the fact that fewer pulmonologists believe that inhaled corticosteroids improve lung function, said Daphne Monie, Ph. D., analyst at Decision Resources. "However, most clinicians are convinced that inhaled corticosteroids decrease exacerbations, and nearly all clinicians believe they should be used in COPD patients with frequent exacerbations."
The report also finds that COPD therapies, which are primarily expensive, branded products, generally fall into higher, less favorable tiers and are subject to numerous cost control measures in private, Medicare, and Medicare Advantage prescription drug plans.
"Most orally available COPD drugs and those delivered by a metered dose inhaler or a dry powder inhaler are covered under the pharmacy benefit of most health plans, while nebulized formulations more often fall under the medical benefit or are not covered," says Monie. "In general, long-acting COPD therapies fall into the second or third tiers and short-acting therapies fall into the first or second tiers of most health plans, but some plans utilize a fourth tier for Sepracor's Xopenex."
PhysicianForum is a primary research service from Decision Resources that offers access to high volume-prescribing physicians, specialists, and managed care organization representatives in the United States; analysis of events and survey participants' responses to them; insight into prescribing patterns; and an examination of the implications of events and issues for the pharmaceutical market.
Chronic Obstructive Pulmonary Disease: Evolving Treatment and Reimbursement is based on a U.S. survey of 91 primary care physicians, 52 pulmonologists, and 24 pharmacy directors. Their responses were compared to assess similarities and differences of opinion regarding clinical, economic, and scientific factors.
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SOURCE: Decision Resources
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