The Burden of Illness in Patients with Moderate to Severe Chronic Obstructive Pulmonary Disease in Canada

Abstract

The current costs associated with moderate and severe COPD are considerable and will increase in the future. Appropriate use of medications and strategies to prevent hospitalizations for AECOPD may reduce COPD-related costs because these were the major cost drivers.

Burden of chronic obstructive pulmonary disease: Healthcare costs and beyond

“…3,4,39 -42 In a Canadian study, 95% of the patients had one or more comorbidities, with cardiovascular being the most common (75.1%). 40 Mental health comorbidities are associated with and exacerbate COPD. For example, one study found only 1.5% of COPD patients suffered from substance abuse but had the largest association with increased hospital admission.…”

“…59 A similar study out of Canada looked at moderate to severe COPD patients and determined the mean cost per exacerbation was $3036 Canadian dollars with hospitalization representing 80% of the total. 40 There also seem to be two COPD populations: patients with frequent exacerbations and patients that do not have exacerbations. These phenotypes are highlighted in the new GOLD criteria (Fig.…”

“…Frequent exacerbators cohort had 2.5 exacerbations per personyears, 39 and the likelihood of having another exacerbation increased with a history of two or more exacerbations in the previous year and/or increasing severity of disease. 4,40 Exacerbations are treated with oral corticosteroids, which have shown to decrease the burden of exacerbations by shortening recovery time, improvement of lung function, and arterial hypoxemia. They also reduce the risk of relapse, treatment failure, and the length of hospital stay, all reducing the overall cost.…”

“…Both the costs for maintenance therapy and acute treatment increased as severity level increased. 40 An interesting retrospective case-control study looked at the cost of health care 36 months before the diagnosis of COPD. COPD patients used 1.5-1.6 times more ED services and inpatient services and had more outpatient visits.…”

“…When evaluated according to GOLD severity, the percentage of patients taking inhaled corticosteroid/long-acting ␤-agonist (LABA) combination, LABA and long-acting anticholinergic medications was greater in patients with more severe COPD. 40 In the Canadian study, 70% of the $2475 per patient was from medication for maintenance treatment in moderate to severe COPD patients. 40 In the U.S., prescription costs for COPD in 2008 were $20.4 billion.…”