Economic Burden of COPD in the Presence of Comorbidities

Abstract

BACKGROUND:The morbidity and mortality associated with COPD exacts a considerable economic burden. Comorbidities in COPD are associated with poor health outcomes and increased costs. Our objective was to assess the impact of comorbidities on COPD-associated costs in a large administrative claims dataset.METHODS:This was a retrospective observational study of data from the Truven Health MarketScan Commercial Claims and Encounters and the MarketScan Medicare Supplemental Databases from January 1, 2009, to September 30, 2012. Resource consumption was measured from the index date (date of first occurrence of non-rule-out COPD diagnosis) to 360 days after the index date. Resource use (all-cause and disease-specific [ie, COPD- or asthma-related] ED visits, hospitalizations, office visits, other outpatient visits, and total length of hospital stay) and health-care costs (all-cause and disease-specific costs for ED visits, hospitalizations, office visits, and other outpatient visits and medical, prescription, and total health-care costs) were assessed. Generalized linear models were used to evaluate the impact of comorbidities on total health-care costs, adjusting for age, sex, geographic location, baseline health-care use, employment status, and index COPD medication.RESULTS:Among 183,681 patients with COPD, the most common comorbidities were cardiovascular disease (34.8%), diabetes (22.8%), asthma (14.7%), and anemia (14.2%). Most patients (52.8%) had one or two comorbidities of interest. The average all-cause total health-care costs from the index date to 360 days after the index date were highest for patients with chronic kidney disease ($41,288) and anemia ($38,870). The impact on total health-care costs was greatest for anemia ($10,762 more, on average, than a patient with COPD without anemia).CONCLUSIONS:Our analysis demonstrated that high resource use and costs were associated with COPD and multiple comorbidities.

Mortality Outcomes of Patients with Chronic Kidney Disease and Chronic Obstructive Pulmonary Disease

“…Data from a large claims database (Truven Health MarketScan Commercial Claims and Encounters and the MarketScan Medicare Supplemental Databases) showed that COPD- or asthma-related total health-care costs were greatest among patients with COPD and asthma and CKD ($41,288 for the first year after the diagnosis of CKD). Our results add to the existing literature about the mortality burden among this population and argue for further studies to elucidate the important clinical factors associated with COPD among those with CKD(26). …”

Chronic obstructive pulmonary disease comorbidities

“…However, beyond the simple co-occurrence of two diseases, recent research efforts have proved that there are unique interactions between COPD and certain specific chronic conditions. Some diseases could influence COPD outcomes (disease progression and exacerbation frequency), including higher costs [4] and mortality [5]; other diseases could be present selectively among a unique subgroup of COPD (currently described as phenotypes) [6]; and, finally, the presence of some chronic conditions could influence decisions about COPD management. In this article, we will review the current knowledge about frequency and mechanisms responsible for the most common COPD comorbidities, and recent advances in the field.…”

Calidad de vida relacionada con la salud en personas chilenas con enfermedad pulmonar obstructiva crónica

“…2 departamento de economía aplicada de la universidad de Murcia, Murcia, españa. 3 instituto de actividad Física, salud y calidad de vida. universidad autónoma de chile.…”

“…El impacto epidemiológico, social y económico de la EPOC es enorme. Se espera que sea la causante del 7,8% del total de muertes, la cuarta causa de muerte en el mundo en 2030 2 y suponiendo una carga económica sustancial 3 . Los pacientes que sufren EPOC a menudo tienen una mala calidad de vida relacionada con la salud (CVRS), incluso al inicio de la enfermedad 4 debido a sus síntomas, a la reducción en la capacidad de realizar actividades de la vida diaria y al uso de medicamentos.…”