We are pleased to announce that our study, exploring barriers to accessing triple therapy for COPD management in primary care across Europe, was presented at the 12th International Care Respiratory Group (IPCRG) World Conference in Athens. The research looked at the variation in the pharmacological management of COPD due to payer-driven access criteria for triple therapy using qualitative insights from a Pan-European cross-expertise panel.
We conducted 14 expert interviews across nine European countries (Austria, Belgium, England, France, Germany, Italy, Netherlands, Portugal, and Spain) with 11 clinicians, 2 representatives from Patient Advocacy Groups (PAGs), and 1 health economist. We used thematic content analysis to synthesise their views on the topic.
Although the payer’s intentions for placing these criteria are typically to contain costs and ensure appropriate prescriptions, the experts perceived them as having unintended consequences that undermine the clinical autonomy of primary care providers (PCPs) in managing COPD patients effectively.
Access and reimbursement criteria imposed by payers have a tangible impact on how COPD is managed in practice, particularly in primary care. These criteria disproportionally affect access to single-inhaler triple therapy (SITT), regardless of its improved effectiveness, mortality reduction and cost-saving effects compared to multiple-inhaler triple therapy (MITT), otherwise known as open triple.
In 7 out of 9 countries we studied, national payers either do not apply access criteria for triple therapy in primary care or have recently lifted such restrictions (Spain and France). From our sample, only Italy and Austria restrict SITT initiation in primary care. Across the rest of the European Union, Bulgaria, Czech Republic, Greece, Hungary, Lithuania, and Romania still apply some form of access restrictions for SITT, typically limiting the ability of primary care providers (PCPs) to initiate triple therapy. The experts believe that these limitations prevent PCPs from making timely treatment decisions, leading to barriers and inequalities in COPD care.
The findings suggest the need for ongoing dialogue on improving access to the full range of treatment options for COPD in primary care, ensuring that patients receive the most effective and convenient treatment options at the point of contact with the healthcare system, and empowering PCPs to make informed decisions in the best interest of their patients.
The conference abstract is available at the IPCRG website: https://www.ipcrg.org/24157.
Citation
Di Marco, F., Shahaj, O., Valipour, A., Legrand, B., Jommi, C., Micheletto, C., Vogelmeier, C. F., Freeman, D., Kocks, J., Alves, L., Rubio, M. C., Peche, R., Palkonen, S., Winders, T., & Roche, N. (2023). Variations in the pharmacological management of COPD due to payer-driven access criteria for triple therapy: Pan-European cross-expertise qualitative insights. International Primary Care Respiratory Group. https://www.ipcrg.org/24157
To learn more about our work at Aquarius, please visit our website or email us at info@aquariusph.com