Economic burden of diagnosed pertussis among individuals with asthma or chronic obstructive pulmonary disease in the USA: an analysis of administrative claims

Abstract

SUMMARYIndividuals with chronic respiratory conditions may be at increased risk for pertussis. We conducted a retrospective administrative claims analysis to examine the incidence and economic burden of diagnosed pertussis among adolescents and adults in the USA with chronic obstructive pulmonary disease (COPD) or asthma. Patients aged ⩾11 years with diagnosed pertussis and pre-existing COPD (n = 343) or asthma (n = 1041) were matched 1:1 to patients with diagnosed pertussis but without COPD or asthma. Differences in all-cause costs (‘excess’ costs) during the 45-day and 3-month and 6-month periods before and after the pertussis index date were calculated; adjusted excess costs were estimated via multivariate regressions. The incidence of diagnosed pertussis was higher among patients with COPD or asthma than among matched patients. Compared with matched patients, patients with pertussis and pre-existing COPD or asthma accrued greater all-cause adjusted costs across study periods ($3694 and $1193 more, respectively, in the 45-day period; $4173 and $1301 more in the 3-month period; and $6154 and $1639 more in the 6-month period; all P < 0·0001). Patients with pre-existing COPD or asthma experience an increased economic burden after diagnosed pertussis and may especially benefit from targeted tetanus, diphtheria, and acellular pertussis vaccination strategies.

Pertussis (whooping cough)

“…Outbreaks of pertussis have been reported periodically every two to five years, mainly in adolescents and adults 11. Overweight or obese people and those with pre-existing respiratory conditions such as chronic obstructive pulmonary disease (COPD) or asthma are at increased risk 121314…”

The unmet need for pertussis prevention in patients with chronic obstructive pulmonary disease in the Italian context

“…The study analyzed records from a large group of eligible patients who had been diagnosed with pertussis and had pre-existing asthma or COPD and compared these to records from individuals diagnosed with pertussis but without asthma or COPD. 34 The salient findings of this study 34 on the number of diagnosed pertussis among adolescents and adults with preexisting COPD or asthma are summarized in Table 1.…”

“…Summary of the findings from a United States retrospective cohort study evaluating the incidence and economic burden of diagnosed pertussis in individuals with COPD or asthma. 34 a) Incidence of diagnosed pertussis among adolescents and adults with pre-existing COPD or asthma Diphtheria and tetanus pathologies are mediated by their respective bacterial toxins. Since tetanus is directly acquired from the environment, herd immunity is not possible although in some countries, maternal immunization protecting infants during the neonatal period is recommended.…”

Pertussis in High Risk Groups: An Overview of the Past Quarter Century

“…24 Asthma Three studies have shown that individuals with underlying asthma are at increased risk of pertussis diagnosis compared to individuals without, as further illustrated by two case studies ( Figure 3). [28][29][30][31][32] A retrospective, population-based case-control study compared the history of asthma in children and adults who had pertussis (confirmed by polymerase chain reaction, PCR) with age-and sex-matched controls during a pertussis outbreak between 2004 and 2005 in California, USA. Of the 164 cases, 38% had asthma before the pertussis diagnosis compared to 26% of the 328 controls, resulting in an adjusted odds ratio of 1.73 (95% confidence interval [CI]: 1.12-2.67, P = .013).…”