Observational studyInternational journal of clinical practice2014
Impact of changes to reimbursement of fixed combinations of inhaled corticosteroids and long-acting β₂ -agonists in obstructive lung diseases: a population-based, observational study.
Observational study in International journal of clinical practice, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- Methods to assess COPD medications adherence in healthcare databases: a systematic review.European respiratory review : an official journal of the European Respiratory Society · 2023Pooled it
- Systematic Literature Review of Systemic Corticosteroid Use for Asthma Management.American journal of respiratory and critical care medicine · 2020Pooled it
- Key factors for implementing inhaler regimen switches in respiratory diseases: international expert consensus generated using a modified nominal group technique (NGT).NPJ primary care respiratory medicine · 2026Article
- Defined daily dose definition in medication adherence assessment in asthma.European clinical respiratory journal · 2023Article
- Reducing carbon footprint of inhalers: analysis of climate and clinical implications of different scenarios in five European countries.BMJ open respiratory research · 2021Article
- Association of Nonmedical Switches in Inhaled Respiratory Medications with Disruptions in Care: A Retrospective Prescription Claims Database Analysis.Pulmonary therapy · 2021Article
- Health-care Resource Requirements and Potential Financial Consequences of an Environmentally Driven Switch in Respiratory Inhaler Use in England.Journal of health economics and outcomes research · 2021Article
- The Impact of a Forced Non-Medical Switch of Inhaled Respiratory Medication Among Patients with Asthma or Chronic Obstructive Pulmonary Disease: A Patient Survey on Experience with Switch, Therapy Satisfaction, and Disease Control.Patient preference and adherence · 2020Article
- Quality standards in respiratory real-life effectiveness research: the REal Life EVidence AssessmeNt Tool (RELEVANT): report from the Respiratory Effectiveness Group-European Academy of Allergy and Clinical Immunology Task Force.Clinical and translational allergy · 2019Article
- Improvement In Self-Reported Physical Functioning With Tiotropium/Olodaterol In Central And Eastern European COPD Patients.International journal of chronic obstructive pulmonary disease · 2019Observational
- The impact of unsupervised and unconsented switch of inhalers in patients with controlled asthma - A targeted literature review.Annals of thoracic medicineReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn 2010, the Icelandic government introduced a new cost-saving policy that limited reimbursement of fixed inhaled corticosteroid/long-acting β₂ -agonist (ICS/LABA) combinations.
methodsThis population-based, retrospective, observational study assessed the effects of this policy change by linking specialist/primary care medical records with data from the Icelandic Pharmaceutical Database. The policy change took effect on 1 January 2010 (index date); data for the year preceding and following this date were analysed in 8241 patients with controlled/partly controlled asthma and/or chronic obstructive pulmonary disease (COPD) who had been dispensed an ICS/LABA during 2009. Oral corticosteroid (OCS) and short-acting β₂ -agonist (SABA) use, and healthcare visits, were assessed pre- and post-index.
resultsThe ICS/LABA reimbursement policy change led to 47.8% fewer fixed ICS/LABA combinations being dispensed during the post-index period among patients whose asthma and/or COPD was controlled/partly controlled during the pre-index period. Fewer ICS monocomponents were also dispensed. A total of 48.6% of patients were no longer receiving any respiratory medications after the policy change. This was associated with reduced disease control, as demonstrated by more healthcare visits (44.0%), and more OCS (76.3%) and SABA (51.2%) dispensations.
conclusionsOverall, these findings demonstrate that changes in healthcare policy and medication reimbursement can directly impact medication use and, consequently, clinical outcomes and should, therefore, be made cautiously.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.