Incremental costs of COPD exacerbations in GOLD stage 2+ COPD in ever-smokers of a general population. (November 2020)

• Record Type: Journal Article
• Authors: Erdal, Marta; Johannessen, Ane; Bakke, Per; Gulsvik, Amund; Eagan, Tomas Mikal; Nielsen, Rune
• Is Part Of: Respiratory medicine. Volume 2(2020)
• Publication Date: 2020-11
• Subjects: Chronic obstructive pulmonary disease -- Costs -- Exacerbations -- General population; Chest -- Diseases -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; 616.2005
• DOI: 10.1016/j.yrmex.2020.100014
• Languages: English
• ISSNs: 2590-1435

Abstract

Abstract: Objectives: To estimate treatment- and productivity-related costs associated with COPD in two different samples, and to analyse the association between the costs and moderate and severe exacerbations. Methods: We performed a baseline visit and four telephone-interviews during a one-year follow-up of 81 COPD cases and 132 controls recruited from a population-based sample, and of 205 hospital-recruited COPD patients. COPD was defined by post-bronchodilator spirometry. Total costs consisted of treatment related costs and costs of productivity losses. Exacerbation-related costs were estimated by multivariate median regression. Results: The average annual disease-related costs for a COPD patient from the hospital sample was nearly twice as high as for a COPD case from the population sample (€26, 518 vs €15, 021), and nearly four times as high as for a control subject (€6740). For both sampling sources, the average annual costs of productivity losses were substantially higher than the treatment related costs (€17, 014 vs €9, 504, €11, 192 vs €3, 829, and €4494 vs €2, 246, for the hospital COPD patients, the population-based COPD cases, and the controls, respectively). Severe exacerbations were an important cost driver for the treatment related costs in both COPD groups. Moderate exacerbations explained all the costs of productivity losses in the population-based COPD cases, but did not affect the costs of productivity losses in the hospital-recruited COPD patients. Conclusion: We found that there were significant incremental costs associated with COPD, and the treatment related costs were significantly affected by exacerbations. The costs of productivity losses substantially exceeded the treatment related costs in both sampling sources. Highlights: The average annual disease-related costs for a COPD patient from a hospital register was twice as high as for a COPD case from a general population. In a general population, moderate exacerbations fully explained all the costs of productivity losses for those with an FEV1 < 50% of predicted. For the hospital sample, severe exacerbations explained a large part of the treatment-related costs, but not the costs of productivity losses. Increasing severity of airflow obstruction was associated with increased costs in both samples. Sampling source is of great importance when evaluating cost-of-illness studies of COPD.