Social economic costs of COPD in Extremadura (Spain): an observational study

Merino, María; Villoro, Renata; Hidalgo, Álvaro; Carmona, Concepción

doi:10.2147/copd.s167357

Cited by 13 publications

(22 citation statements)

References 24 publications

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“…Given the perspective of the analysis, indirect costs were not included in the base case. Some studies have calculated the indirect costs associated with COPD in Spain, 48,49 but those studies do not report the indirect costs specifically associated with exacerbations. Despite the advanced age of patients with COPD, if a societal perspective was adopted, the savings could have been slightly higher.…”

Section: Discussionmentioning

confidence: 99%

Estimation of the Clinical and Economic Impact of an Improvement in Adherence Based on the Use of Once-Daily Single-Inhaler Triple Therapy in Patients with COPD

Miravitlles¹,

Marín²,

Huerta³

et al. 2020

COPD

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Background: Adherence to treatment is key to achieve desired outcomes. In COPD, adherence is generally suboptimal and is impaired by treatment complexity. Objective: To estimate the clinical and economic impact of an improvement in treatment adherence due to an increased use of once-daily single-inhaler triple therapy (SITT) in patients with COPD. Patients and Methods: A 7-state Markov model with monthly cycles was developed. Patients with moderate-to-very severe COPD, for whom triple therapy is indicated, were included. Outcomes and costs were estimated and compared for two scenarios: current distribution of adherent patients treated with multiple inhaler triple therapies (MITT) vs a potential scenario where patients shifted to once-daily SITT. In the potential scenario, adherence improvement due to once-daily SITT attributes was estimated. Costing was based on the Spanish National Health System (NHS) perspective (€2019). A 3-year time horizon was defined considering a 3% discount rate for both costs and outcomes. Results: A target population of 185,111 patients with moderate-to-very severe COPD currently treated with MITT was estimated. A 20% increase in the use of once-daily SITT in the potential scenario raised adherence up to 52%. This resulted in 6835 exacerbations and 532 deaths avoided, with 775 LYs and 594 QALYs gained. Total savings reached €7,082,105. Exacerbation reduction accounted for 61.8% (€4,378,201) of savings. Conclusion: Increasing the use of once-daily SITT in patients with moderate-to-very severe COPD treated with triple therapy would be associated with an improvement in adherence, a reduction of exacerbations and deaths, and cost savings for the Spanish NHS.

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Section: Discussionmentioning

confidence: 99%

Estimation of the Clinical and Economic Impact of an Improvement in Adherence Based on the Use of Once-Daily Single-Inhaler Triple Therapy in Patients with COPD

Miravitlles¹,

Marín²,

Huerta³

et al. 2020

COPD

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“…4 In 2018, the average annual direct cost of COPD in Spain was estimated to be €1645 per patient, with an additional €2112 in indirect costs. 5 Healthcare costs in COPD vary according to the patient's level of symptoms, 1,6,7 with the frequency and severity of exacerbations having the greatest economic impact. 8,9 In 2016, the cost of COPD in Spain was €3200 per patient per year (PPPY) in individuals who experienced exacerbations, and €1403 PPPY in those without exacerbations.…”

Section: Introductionmentioning

confidence: 99%

“… 4 In 2018, the average annual direct cost of COPD in Spain was estimated to be €1645 per patient, with an additional €2112 in indirect costs. 5 …”

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness Analysis of a Once-Daily Single-Inhaler Triple Therapy for Patients with Chronic Obstructive Pulmonary Disease (COPD) Using the FULFIL Trial: A Spanish Perspective

Schroeder¹,

Benjamin²,

Atienza³

et al. 2020

COPD

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Purpose: To evaluate the cost-effectiveness of once-daily fluticasone furoate/umeclidinium/ vilanterol (FF/UMEC/VI) vs twice-daily budesonide/formoterol (BUD/FOR) in patients with symptomatic chronic obstructive pulmonary disease (COPD) at risk of exacerbations, from the Spanish National Healthcare System perspective. Patients and Methods: The validated GALAXY-COPD model was used to simulate disease progression and predict healthcare costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) over a 3-year time horizon for a Spanish population. Patient characteristics from published literature were supplemented by data from FULFIL (NCT02345161), which compared FF/UMEC/VI vs BUD/FOR in patients with symptomatic COPD at risk of exacerbations. Treatment effects, extrapolated to 3 years, were based on Week 24 results in the FULFIL intent-to-treat population, including change in forced expiratory volume in 1 second, St. George's Respiratory Questionnaire score, and exacerbation rates. Treatment, exacerbations, and COPD management costs (2019€) were informed by Spanish public sources and published literature. A 3% discount rate for costs and benefits was applied. One-way sensitivity and scenario analyses, and probabilistic sensitivity analysis (PSA), were performed. Results: FF/UMEC/VI treatment led to fewer moderate and severe exacerbations (2.126 and 0.306, respectively) vs BUD/FOR (2.608 and 0.515, respectively), with a mean incremental cost of €69 and gain of 0.107 QALYs, which resulted in an ICER of €642 per QALY gained. In sensitivity analyses, the ICER was most sensitive to treatment effect variations in exacerbations and healthcare resource utilization/event costs. Overall, 95% of 1000 PSA simulations resulted in an ICER less than €11,000 per QALY gained for FF/UMEC/VI vs BUD/FOR, confirming robustness of the results. The probability of FF/UMEC/VI being cost-effective vs BUD/FOR was 100% at a willingness-to-pay threshold of €30,000 per QALY gained. Conclusion: At the accepted Spanish ICER threshold of €30,000, FF/UMEC/VI represents a cost-effective treatment option vs BUD/FOR in patients with symptomatic COPD at risk of exacerbations.

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“…This study uses data from a larger study dedicated to the socio-economic burden of COPD in Extremadura [17]. This was a cross-sectional observational study that used probabilistic sampling stratified by Health Area in order to obtain a representative sample of patients with COPD in Extremadura.…”

Section: Methodsmentioning

confidence: 99%

“…The secondary objective was to explore the relationship between HRQL and several socio-demographic and clinical characteristics of the patients. The data used are part of a study on the total socioeconomic burden of COPD in Extremadura, which describes the economic costs of COPD, and the association between poorer HRQL and increased consumption of health resources [17]. The information provided in this paper complements those results and may prove useful in the design of preventive measures and in decision making related to the appropriate management of COPD.…”

Section: Introductionmentioning

confidence: 99%

Health-related quality of life of patients diagnosed with COPD in Extremadura, Spain: results from an observational study

Merino

Villoro

Hidalgo

et al. 2019

Health Qual Life Outcomes

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BackgroundCOPD is a high prevalence chronic disease that involves large reductions of health-related quality of life (HRQL) of patients. This study aims to describe the HRQL of patients with COPD in Extremadura (Spain).MethodsThis is a cross-sectional observational study carried out using a representative sample of patients diagnosed with COPD in Extremadura. The inclusion criteria were patients of legal age, diagnosed with COPD at least 12 months prior to the visit, residing in Extremadura, with electronic medical records available for the 12 months prior to the visit and providing informed consent. The intervention aimed to elicit HRQL indicators obtained from two validated questionnaires: EuroQol - 5 Dimensions - 5 Levels (EQ-5D-5L), and St. George’s Respiratory Questionnaire-COPD (SGRQ-C). The main outcome measures were general HRQL (utility and visual analogue scale) and specific quality of life of COPD patients (total score and three component scores: Symptoms, Activity, and Impacts). Stepwise multiple regression analysis was applied to evaluate the association of EQ-5D-5L and SGRQ-C with respect to clinical and sociodemographic characteristics of the patients.ResultsWe recruited 386 patients (mean age 71.8 ± 10.3 years, 76.2% males). In the EQ-5D-5L, participants reported greater problems with respect to mobility (56.5%) and pain/discomfort (48.2%). The mean utility was 0.72 ± 0.31, and the SGRQ-C total score was 40.9 ± 25.0. The results of both questionnaires were associated with number of exacerbations in the last 12 months, level of COPD severity, gender, and education level of the patient (p < 0.05).ConclusionsThe results for both utility and total SGRQ-C score indicate that having suffered exacerbations in the last year, presenting a higher level of severity, being a woman, and having a low education level are related to worse HRQL in patients with COPD.

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Social economic costs of COPD in Extremadura (Spain): an observational study

Cited by 13 publications

References 24 publications

<p>Estimation of the Clinical and Economic Impact of an Improvement in Adherence Based on the Use of Once-Daily Single-Inhaler Triple Therapy in Patients with COPD</p>

<p>Estimation of the Clinical and Economic Impact of an Improvement in Adherence Based on the Use of Once-Daily Single-Inhaler Triple Therapy in Patients with COPD</p>

<p>Cost-Effectiveness Analysis of a Once-Daily Single-Inhaler Triple Therapy for Patients with Chronic Obstructive Pulmonary Disease (COPD) Using the FULFIL Trial: A Spanish Perspective</p>

Health-related quality of life of patients diagnosed with COPD in Extremadura, Spain: results from an observational study

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