Abstract
No recent Canadian studies with physician- and spirometry-confirmed diagnosis of chronic obstructive pulmonary disease (COPD) that assessed the burden of COPD have been published. To assess the costs associated with maintenance therapy and treatment for acute exacerbations of COPD (AECOPD) over a one-year period. Respirologists, internists and family practitioners from across Canada enrolled patients with an established diagnosis of moderate to severe COPD (Global initiative for chonic Obstructive Lung Disease stages 2 and 3) confirmed by postbronchodilator spirometry. Patient information and health care resources related to COPD maintenance and physician-documented AECOPD over the previous year were obtained by chart review and patient survey. A total of 285 patients (59.3% male; mean age 70.4 years; mean pack years smoked 45.6; mean duration of COPD 8.2 years; mean postbronchodilator forced expiratory volume in 1 s 58.0% predicted) were enrolled at 23 sites across Canada. The average annual COPD-related cost per patient was $4,147. Across all 285 patients, maintenance costs were $2,475 per patient, of which medications accounted for 71%. AECOPD treatment costs were $1,673 per patient, of which hospitalizations accounted for 82%. Ninety-eight patients (34%) experienced a total of 157 AECOPD. Treatment of these AECOPD included medications and outpatient care, 19 emergency room visits and 40 hospitalizations (mean length of stay 8.9 days). The mean cost per AECOPD was $3,036. The current costs associated with moderate and severe COPD are considerable and will increase in the future. Appropriate use of medications and strategies to prevent hospitalizations for AECOPD may reduce COPD-related costs because these were the major cost drivers.
Highlights
InTRoduCTIon: No recent Canadian studies with physician- and spirometry-confirmed diagnosis of chronic obstructive pulmonary disease (COPD) that assessed the burden of COPD have been published. oBJECTIVE: To assess the costs associated with maintenance therapy and treatment for acute exacerbations of COPD (AECOPD) over a oneyear period
Patient information and health care resources related to COPD maintenance and physician-documented AECOPD over the previous year were obtained by chart review and patient survey
Figure 1) Annual frequency of acute exacerbations of chronic obstructive pulmonary diease (AECOPD) per patient according to Global initiative for chronic Obstructive Lung Disease (GOLD) COPD severity ward and days spent in the intensive care unit
Summary
Ontario Case Costing Initiative; OSB-LF The Ontario Schedule of Benefits for Laboratory Fees; OSB-PS The Ontario Schedule of Benefits for Physician. A Canadian survey of COPD patients conducted in 2000/2001 reported an annual COPD-related cost of $3,195 per patient [15]. The prospective Resource Use Study in COPD (RUSIC), conducted in 2001/2002, reported costs to the health care system of $641 and $9,557 per patient for moderate and severe AECOPD, respectively [16]. The objective of the present study was to assess the direct and indirect costs associated with maintenance therapy and treatment for AECOPD in a real-world setting over a one-year period among patients with moderate to severe (Global initiative for chronic Obstructive Lung Disease [GOLD] 2 and 3) COPD using data from patient medical records and patient surveys. The site provided the number and type of health care resources used for maintenance treatment of COPD (when patients were not experiencing an AECOPD as defined above). For patients who were hospitalized, the study did not collect data regarding whether the patient burden of illness in COPD patients in Canada
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