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Around 15,000 Kiwis living with chronic obstructive pulmonary disease (COPD), the fourth leading cause of death in NZ, could benefit from the funding of a new medicine that will allow them to switch from using multiple inhalers to the first single inhaler treatment for the disease.[1][2][3]
COPD refers to a group of diseases like bronchitis and emphysema that cause airflow blockage and breathing-related problems.[4]
COPD is often underdiagnosed, and it is estimated to affect approximately 200,000 (15%) of all New Zealanders aged over 45 years. The burden of the disease is inequitably borne by Maori and Pacific people who are more likely to be diagnosed with and are more severely impacted by COPD.[5][6][7][8]
A study of over 73,000 people has shown that half of all patients died within four years of their first hospitalisation for a severe COPD exacerbation. An exacerbation is also known as a flare up.[9][10]
Hospitalisation rates for Maori are nearly four times as high as those of European or other ethnicities (excluding Asian and Pacific people).[11]
By region, hospitalisation rates for Maori are highest in the Central and Te Manawa Taki regions and for Pacific people in the Northern region.[12]
Amongst New Zealanders aged 50–64 years, Maori are approximately five times more likely to die from COPD-related causes than non-Maori and are affected by COPD up to 20 years earlier.[13]
Specialist Dr Robert Young says COPD is difficult to diagnose and many patients dismiss their symptoms such as breathlessness (easily puffed) as a normal part of the ageing process.[14][15][16][17]
“Often people with COPD don’t even mention to their healthcare provider that they are experiencing shortness of breath during normal daily activities, as they may believe it is just part of growing older when it can be the first signs that they have COPD,” he says.[18][19]
Dr Young says the quality of life for those with the disease is significantly diminished.[20][21]
“The impact on patients can be devastating. Their world shrinks around them, and they find they can do less, feel weaker, and can walk only short distances. The simple things they took for granted become more and more difficult for them as their lung disease progresses such that they can end up being limited to walking around their house in the very advanced stages of the disease,” he says.[22][23][24]
Dr Young says he would like to see greater intervention at the early stages of the disease and greater use of spirometry, a common lung function test to diagnose COPD in its earliest stages.[25][26]
“Spirometry is a clinical test that measures how well a patient's lungs are working by measuring how quickly and how much air can be exhaled. Patients blow into the device for as long as they can, and the expelled air can be calculated in litres per second. This simple test could be routinely performed at GP offices, or perhaps pharmacies in the future, to help identify the presence of COPD,” he says.[27]
“We know globally that during the past 30 years, the number of COPD cases and deaths have increased significantly, yet 70-80% of adults with the disease remain undiagnosed.[28]
Dr Young says early intervention, quitting smoking and subsequent treatment will not only improve the lives of those living with COPD but help address the burden of disease.[29][30]
“COPD continues to have a significant health and economic impact. Patients must live with a reduced quality of life and increased likelihood of additional comorbidities, in turn putting additional economic strain on resources.
Research shows that with earlier diagnosis and treatment there may be improvements in disease progression and patient outcomes,” he says.[31][32][33][34]
In the first year of funding, around 15,000 Kiwis living with COPD will be able to step up from using 2 in 1 combination inhalers or switch from multiple inhaler triple therapy to a single 3 in 1 inhaler triple-therapy combination known as Trelegy Ellipta.[35][36][37]
Amanda Southcombe, GSK NZ General Manager, says the funding of Trelegy Ellipta will provide more equitable outcomes for patients.[38]
“We are pleased to see more Kiwis suffering from moderate to severe COPD receive access to more treatment options available to them to help better deal with their symptoms,” she says.[39][40]
[1] Pharmac. (2024, April 12). Summary of decision: single inhaler triple-therapy for COPD - Pharmac | New Zealand Government. https://pharmac.govt.nz/news-and-resources/news/summary-of-decision-single-inhaler-triple-therapy-for-copd#:~:text=Fluticasone%20furoate%20with%20umeclidinium%20and,instead%20of%20two%20or%20three. [Accessed August 2024].
[2] Pharmac. (2024, April 12). Decision to fund treatments for ovarian cancer, respiratory disorders, infectious - Pharmac | New Zealand Government. https://pharmac.govt.nz/news-and-resources/consultations-and-decisions/decision-to-fund-treatments-for-ovarian-cancer-respiratory-disorders-infectious-diseases-and-vasculitis. [Accessed August 2024].
[3] GlaxoSmithKline. Trelegy Ellipta Data Sheet. https://www.medsafe.govt.nz/profs/datasheet/t/TrelegyElliptapowder.pdf. [Accessed August 2024].
[4] Health status Report – Health New Zealand | Te Whatu Ora. (February,2024). https://www.tewhatuora.govt.nz/publications/health-status-report/. [Accessed August 2024].
[5] GOLD 2024 Report. Global Initiative for Chronic Obstructive Lung Disease. Available at www.goldcopd.org. [Accessed August 2024].
[6] Pharmac. (2024, April 12). Summary of decision: single inhaler triple-therapy for COPD - Pharmac | New Zealand Government. https://pharmac.govt.nz/news-and-resources/news/summary-of-decision-single-inhaler-triple-therapy-for-copd#:~:text=Fluticasone%20furoate%20with%20umeclidinium%20and,instead%20of%20two%20or%20three. [Accessed August 2024].
[7] Asthma Foundation NZ. (2022, November 29). https://www.asthmafoundation.org.nz/research/key-statistics#:~:text=Chronic%20obstructive%20pulmonary%20disease%20(COPD)%20in%20New%20Zealand%3A,Broad%20%26%20Jackson%2C%202003. [Accessed August 2024].
[8] Health status Report – Health New Zealand | Te Whatu Ora. (February,2024). https://www.tewhatuora.govt.nz/publications/health-status-report/. [Accessed August 2024].
[9] Suissa S; Long-term natural history of chronic obstructive pulmonary disease: severe exacerbations and mortality;Thorax;2012;67;:957–963.
[10] World Health Organisation. (2023, March 16). Chronic obstructive pulmonary disease (COPD) https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd) . [Accessed August 2024].
[11] Health status Report – Health New Zealand | Te Whatu Ora. (February,2024). https://www.tewhatuora.govt.nz/publications/health-status-report/. [Accessed August 2024].
[12] Health status Report – Health New Zealand | Te Whatu Ora. (February,2024). https://www.tewhatuora.govt.nz/publications/health-status-report/. [Accessed August 2024].
[13] Best Practice Advocacy Centre New Zealand (BPAC). https://bpac.org.nz/bpj/2012/april/copd.aspx. [Accessed August 2024].
[14] Hancox RJ;NZMJ;2021;134;76-110. New Zealand COPD guidelines. https://www.nzrespiratoryguidelines.co.nz/uploads/8/3/0/1/83014052/nz_copd_guidelines_web.pdf. [Accessed August 2024].
[15] GOLD 2024 Report. Global Initiative for Chronic Obstructive Lung Disease. Available at www.goldcopd.org. [Accessed August 2024].
[16] Lin CH, Cheng SL, Chen CZ, Chen CH, Lin SH, Wang HC. Current Progress of COPD Early Detection: Key Points and Novel Strategies. Int J Chron Obstruct Pulmon Dis. 2023 Jul 19;18:1511-1524. doi: 10.2147/COPD.S413969. PMID: 37489241; PMCID: PMC10363346.
[17] Best Practice Advocacy Centre New Zealand (BPAC). https://bpac.org.nz/bpj/2012/april/copd.aspx. [Accessed August 2024].
[18] Hancox RJ;NZMJ;2021;134;76-110. New Zealand COPD guidelines. https://www.nzrespiratoryguidelines.co.nz/uploads/8/3/0/1/83014052/nz_copd_guidelines_web.pdf. [Accessed August 2024].
[19] Best Practice Advocacy Centre New Zealand (BPAC). https://bpac.org.nz/bpj/2012/april/copd.aspx. [Accessed August 2024].
[20] Fletcher MJ;BMC Public Health. 2011;11:1-13.
[21] GOLD 2024 Report. Global Initiative for Chronic Obstructive Lung Disease. Available at www.goldcopd.org. [Accessed August 2024].
[22] Reardon JZ, Am J Med;2006;119;S32-S37.
[23] ZuWallack R. COPD. 2007;4(3):293–297.
[24] Fletcher MJ;BMC Public Health. 2011;11:1-13.
[25] Best Practice Advocacy Centre New Zealand (BPAC) https://bpac.org.nz/BPJ/2015/February/copd-part1.aspx. [Accessed August 2024].
[26] GOLD 2024 Report. Global Initiative for Chronic Obstructive Lung Disease. Available at www.goldcopd.org. [Accessed August 2024].
[27] Best Practice Advocacy Centre New Zealand (BPAC) https://bpac.org.nz/BPJ/2015/February/copd-part1.aspx. [Accessed August 2024].
[28] Lin CH, Cheng SL, Chen CZ, Chen CH, Lin SH, Wang HC. Current Progress of COPD Early Detection: Key Points and Novel Strategies. Int J Chron Obstruct Pulmon Dis. 2023 Jul 19;18:1511-1524. doi: 10.2147/COPD.S413969. PMID: 37489241; PMCID: PMC10363346.
[29] Best Practice Advocacy Centre New Zealand (BPAC). https://bpac.org.nz/bpj/2012/april/copd.aspx. [Accessed August 2024].
[30] GOLD 2024 Report. Global Initiative for Chronic Obstructive Lung Disease. Available at www.goldcopd.org. [Accessed August 2024].
[31] GOLD 2024 Report. Global Initiative for Chronic Obstructive Lung Disease. Available at www.goldcopd.org. [Accessed August 2024].
[32] Fletcher MJ;BMC Public Health. 2011;11:1-13.
[33] Reardon JZ, Am J Med;2006;119;S32-S37.
[34] ZuWallack R. COPD. 2007;4(3):293–297.
[35] Pharmac. (2024, April 12). Summary of decision: single inhaler triple-therapy for COPD - Pharmac | New Zealand Government. Pharmac | New Zealand Government. https://pharmac.govt.nz/news-and-resources/news/summary-of-decision-single-inhaler-triple-therapy-for-copd#:~:text=Fluticasone%20furoate%20with%20umeclidinium%20and,instead%20of%20two%20or%20three. [Accessed August 2024].
[36] Pharmac. (2024, April 12). Decision to fund treatments for ovarian cancer, respiratory disorders, infectious - Pharmac | New Zealand Government. https://pharmac.govt.nz/news-and-resources/consultations-and-decisions/decision-to-fund-treatments-for-ovarian-cancer-respiratory-disorders-infectious-diseases-and-vasculitis. [Accessed August 2024].
[37] GlaxoSmithKline. Trelegy Ellipta Data Sheet. https://www.medsafe.govt.nz/profs/datasheet/t/TrelegyElliptapowder.pdf. [Accessed August 2024].
[38] Pharmac. (2024, April 12). Summary of decision: single inhaler triple-therapy for COPD - Pharmac | New Zealand Government. Pharmac | New Zealand Government. https://pharmac.govt.nz/news-and-resources/news/summary-of-decision-single-inhaler-triple-therapy-for-copd#:~:text=Fluticasone%20furoate%20with%20umeclidinium%20and,instead%20of%20two%20or%20three. [Accessed August 2024].
[39] Pharmac. (2024, April 12). Decision to fund treatments for ovarian cancer, respiratory disorders, infectious - Pharmac | New Zealand Government. https://pharmac.govt.nz/news-and-resources/consultations-and-decisions/decision-to-fund-treatments-for-ovarian-cancer-respiratory-disorders-infectious-diseases-and-vasculitis. [Accessed August 2024].
[40] GlaxoSmithKline. Trelegy Ellipta Data Sheet. https://www.medsafe.govt.nz/profs/datasheet/t/TrelegyElliptapowder.pdf. [Accessed August 2024].
[41] GlaxoSmithKline. Trelegy Ellipta Consumer Medicines Information. https://www.medsafe.govt.nz/consumers/cmi/t/TrelegyEllipta.pdf. [Accessed August 2024].
[42] GlaxoSmithKline. Trelegy Ellipta Data Sheet. https://www.medsafe.govt.nz/profs/datasheet/t/TrelegyElliptapowder.pdf. [Accessed August 2024].
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