ICU, inpatient admission rates related to asthma rise following Flovent discontinuation

Key takeaways:

• GSK halted manufacturing its Flovent HFA and Flovent Diskus fluticasone propionate inhalers in January.
• As a result of this, three types of asthma encounter rates went up.

Following the discontinuation of Flovent in January, ICU admissions, inpatient admissions and ED visits related to asthma rose in comparison with previous years, according to study results from Epic Research.

“[These findings show that the stopped manufacturing of Flovent] adds burden to doctors who are trying their best to be sure patients get the medications they need,” Christopher Alban, MD, clinical informaticist at Epic Systems Corp, told Healio.

“It also illustrates how hard it can be for patients and their caregivers to navigate the complicated U.S. health care system,” Alban continued.

Epic Research is a public benefit corporation that expedites data publication through internal peer review. According to its website, most of its studies use data from 1,587 hospitals and 36,100 clinics that use the Epic System’s electronic health record software (Cosmos dataset).

Additionally, all Epic Research studies are conducted by two teams, which are each made up of a clinician and a data scientist.

As Healio previously reported, GSK halted manufacturing its Flovent HFA and Flovent Diskus fluticasone propionate inhalers but made generic versions available in January.

In this study, both teams assessed 3,312,869 patients with asthma and a prescription for fluticasone propionate (Flovent, authorized generic, another brand or independent generic) within 6 months before the beginning of the first and second quarters of 2022, 2023 and 2024 to see how rates of three different types of asthma encounters — inpatient admissions, ICU admissions and ED visits — after the discontinuation of Flovent differ from rates before the product was discontinued.

After averaging first quarter asthma-related inpatient admission rates from 2022 and 2023 and comparing this rate with the 2024 first-quarter rate, researchers found a rise in this rate in 2024, going from 1,321 patients admitted per 100,000 to 1,551 patients admitted per 100,000, or a 17.5% increase.

The growth of this rate in 2024 vs. 2022 and 2023 was even higher in the second quarter, as 1,338 patients were admitted per 100,000 in the averaged 2022 and 2023 rate, and 1,661 patients were admitted per 100,000 in 2024. The difference between the two rates represents a 24.1% increase in asthma-related inpatient admissions in 2024, according to the study.

Similar to above, researchers reported rises in asthma-related ICU admission rates from the first quarters of 2022 and 2023 averaged to 2024, going from 300 patients to 353 patients admitted to the ICU per 100,000 (17.4% increase).

The difference between the two time periods became even larger when evaluating second quarter rates. According to the study, the number of patients admitted to the ICU per 100,000 was 311 in 2022 and 2023 averaged, whereas this number was 377 in 2024, demonstrating a 21.3% increase.

For asthma-related ED visits, rates were again greater in 2024 vs. averaged 2022 and 2023 in both the first quarter (3,997 vs. 3,753 patients with an ED visit per 100,000; 6.5% increase) and the second quarter (4,023 vs. 3,884 patients with an ED visit per 100,000; 3.6% increase), according to the study.

References:

• About Us. Epic Research. https://epicresearch.org/about-us. Accessed Oct. 22, 2024.
• Epic Cosmos. https://cosmos.epic.com/. Accessed Oct. 22, 2024.