This study is intended to evaluate treatment effectiveness with budesonide/formoterol (BFC) and tiotropium tromide in patients new to ICS/LABA combination and LAMA therapies.

Using US claims data from the HealthCore Integrated Research Environment, COPD patients ≥40 years old initiating BFC or tiotropium between 3/1/2009-2/28/2012 and considered at risk for a future exacerbation were identified and followed for 12 months.

Inclusion Criteria:

• Continuous health plan enrollment for 12 months before and after index Rx
• At least one prescription fill for BFC or tiotropium bromide during intake period, and naive to ICS/LABA combination or LAMA therapies in year prior to first prescription claim.
• COPD diagnosis, and aged 40 years of age at time of first prescription
• At risk population for COPD exacerbations

Exclusion Criteria:

• ICS/LABA combination or LAMA therapy during pre-index period
• Patients with prescription claim for budesonide/formoterol and tiotropium bromide on the same day
• Patients diagnosed with cancer
• Patients with long-term OCS medication use during pre-index period

Health plan members with COPD aged 40 years or older receiving one or more prescriptions of BFC or tiotropium bromide during 3/1/2009 and 1/31/2012 who are naive to ICS/LABA and LAMA combination therapies.