Characteristics of Medicare and Medicaid Patients Initiating Volara Respiratory Therapy: A Medical Claims Study.

introductionVolara is a novel respiratory device that delivers oscillation, lung expansion, and aerosolized medication. This study explores healthcare resource utilization (HCRU) and costs among Medicare and Medicaid enrollees who initiated Volara, providing the first real-world characterization of their HCRU patterns.

methodsWe conducted a descriptive study using administrative claims data to identify Medicare and Medicaid enrollees who initiated Volara. Respiratory-related HCRU, including emergency department (ED) visits and hospitalizations, and associated costs were summarized for the 12-month pre-initiation and 12-month post-initiation periods as annualized rates and per-member-per-month (PMPM) costs. Analyses were stratified by disease segment based on principal diagnosis as of initiation and patient characteristics, including clinical risk, social risk, and age. No formal statistical comparisons between periods were conducted because of small samples and the exploratory nature of the analysis.

resultsAmong Medicare enrollees, ED visit rates and costs for respiratory exacerbations were 58% and 39% lower, respectively, in the post-initiation period compared with the pre-initiation period (26.3 vs 11.0 visits per 100 patients; $21 vs $12 PMPM). Hospitalization rates and costs were also lower post-initiation (41.2 vs 30.4 per 100 patients, 26% lower; $512 vs $456 PMPM, 11% lower). ED visits and costs were lower across subgroups, whereas differences in hospitalization rates were more pronounced among patients with higher clinical risk, higher social risk, and older age. Among Medicaid enrollees, ED utilization patterns were mixed, with similar rates but higher costs post-initiation (31.4 vs 29.6 per 100 patients, 5% lower; $135 vs $168 PMPM, 24% higher). In contrast, hospitalization rates and costs were lower post-initiation overall, though subgroup patterns were heterogeneous.

conclusionThese findings provide an initial characterization of real-world utilization and cost patterns among Volara users. Observed patterns varied across populations and subgroups, underscoring the need for further research using comparative designs and appropriate adjustment for confounding to understand these relationships.