A Retrospective Study of the Effectiveness of the AeroChamber Plus(®) Flow-Vu(®) Antistatic Valved Holding Chamber for Asthma Control

INTRODUCTION: Electrostatic charge in valved holding chambers (VHCs) may lead to inconsistent metered-dose inhaler (MDI) asthma drug delivery. We compared the AeroChamber Plus(®) Flow Vu(®) Antistatic Valved Holding Chamber (AC(+)FV AVHC) with non-antistatic control VHCs in terms of asthma exacerbations, resource use, and cost in an asthma population. METHODS: Patients included in an adjudicated claims database with AC(+)FV AVHC or non-antistatic VHC (control VHC) use between 1/2010 and 8/2015 (index) who were treated with an inhaled corticosteroid (ICS) or a combination of an ICS and a long-acting β2 agonist MDI within 60 days before or after the index date, were diagnosed with asthma, and had ≥12 months of pre- and ≥30 days of post-index health plan enrollment were included. Cohorts were matched 1:1 using propensity scores. We compared incidence rates (IR) of exacerbation, time to first exacerbation using Kaplan–Meier survival analysis, occurrence of exacerbations, and healthcare resource use and costs using generalized linear models. RESULTS: 9325 patients in each cohort were identified. The IR of exacerbations per 100 person-days (95% CI) was significantly higher in the control VHC cohort than the AC(+)FV AVHC cohort [0.161 (0.150–0.172) vs. 0.137 (0.128–0.147)]. A higher proportion of exacerbation-free patients was observed in the AC(+)FV AVHC cohort. Among the 4293 patients in each cohort with ≥12 months of follow-up, AC(+)FV AVHC patients were found to be 10–12% less likely than control VHC patients to experience an exacerbation throughout the study period. A lower proportion of the AC(+)FV AVHC patients had an ED visit compared to the control VHC patients (10.8% vs. 12.4%). Exacerbation-related costs for the AC(+)FV AVHC cohort were 23%, 25%, 20%, and 12% lower than those for the control VHC cohort at 1, 6, 9, and 12 months, respectively. CONCLUSIONS: The AC(+)FV AVHC was associated with lower exacerbation rates, delayed time to first exacerbation, and lower exacerbation-related costs when compared to control non-antistatic VHCs.