Abstract
The aim was to estimate the economic burden, as well as rate of progression of COPD for a cohort of 426 patients for a 10-year period. A total of 426 patients from 19 regions with Chronic Obstructive Pulmonary Disease were enrolled in a representative, ambispective, national study for Bulgaria. Patients were recorded on disease stage, occupation, smoking habits and medication. Cost of treatment was calculated and a 10-year one-way Markov model was used by employing transition probabilities and quality of life data from available literature. Costs and outcomes were recorded and a cost-effectiveness acceptability curve (CEAC) was established. Out of all patients included in the study 288 were non-smokers with a mortality percentage after 10 years of 42.7%. Smokers showed faster transition rate with 139 of them transitioning to more severe states and mortality was 54.6%. The incremental cost-effectiveness ratio (ICER) was 863.75 BGN. Patients who smoked had a lower quality of life – cumulatively for the 10-year period QALY = 623.51 for smokers vs. 1557.51 for non-smokers, but also lower costs for treatment (538 007.52 BGN vs. 1 344 757.95 BGN) accounted by the high transition rate and mortality amongst that group. Relatively few non-smokers transitioned from a less severe to a more severe state (6%), while most of the very severe stage patients experienced a lethal outcome within 10 years (81%). Despite the higher costs associated with the disease, the Quality of Life and lower transition probability would enable patients to live a normal life. The ICER was well below the WHO threshold.
Highlights
Chronic Obstructive Pulmonary Disease (COPD) is rapidly becoming a hugely significant disease, with estimates pointing towards it becoming the second most common diagnosis by 2030 (Murray et al 1996)
Despite the higher costs associated with the disease, the Quality of Life and lower transition probability would enable patients to live a normal life
Of death (Bousqet and Khaltaev 2007). It is defined by the Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) as a “common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation due to exposure to noxious particles and gases”, which makes timely diagnosis and treatment a priority
Summary
Chronic Obstructive Pulmonary Disease (COPD) is rapidly becoming a hugely significant disease, with estimates pointing towards it becoming the second most common diagnosis by 2030 (Murray et al 1996). Of death (Bousqet and Khaltaev 2007) It is defined by the Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) as a “common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation due to exposure to noxious particles and gases”, which makes timely diagnosis and treatment a priority. The ageing population of European Countries, in combination with new medicines and medical devices which prolong life, has increased the frequency of people developing chronic diseases (Yach et al 2004). Effective strategies in managing and preventing the disease require timely diagnosis, appropriate treatment and extensive patient education
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