Incremental costs of COPD exacerbations in GOLD stage 2+ COPD in ever-smokers of a general population

Marta Erdal, Ane Johannessen, Per Bakke, Amund Gulsvik, Tomas Mikal Eagan, Rune Nielsen
2020 Respiratory Medicine: X  
Data management and quality control, statistical analyses, analysis plan, drafting, revision and approval of drafts. Ane Johannessen; Data management and quality control, statistical analyses, analysis plan, drafting, revision and approval of drafts. Per Bakke; Design, planning and data collection, revision and approval of drafts. Amund Gulsvik; Design, planning and data collection, revision and approval of drafts. Tomas Mikal Eagan; Revision and approval of drafts. Rune Nielsen; Design,
more » ... sen; Design, planning and data collection, data management and quality control, statistical analyses, analysis plan, drafting, revision and approval of drafts. ABSTRACT 2 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. Exacerbationrelated 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 (€6,740). 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 €4,494 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.
doi:10.1016/j.yrmex.2020.100014 fatcat:gn4hungvvvegxhs376ovidmbsy