The direct and indirect costs of managing chronic obstructive pulmonary disease in Greece

Souliotis, Kyriakos; Kousoulakou, H.; Hillas, Georgios; Tzanakis, Νikolaos; Toumbis, Michalis; Vassilakopoulos, Theodoros P.

doi:10.2147/copd.s132825

Cited by 36 publications

(39 citation statements)

References 12 publications

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“…There was a considerable impact of COPD on productivity loss in the working-age population, which was evident from the costs incurred due to productivity loss. Indirect costs associated with COPD are significant; in the US, the indirect costs for COPD patients accounted for 27%–61% of the total medical costs, depending on the population studied, while in Greece, it accounted for 37.5% of the annual medical cost for COPD patients 38,39. Although the indirect costs were estimated considering only the productivity loss, the number of patients retiring due to COPD highlights a considerable economic impact of the disease in Japan.…”

Section: Discussionmentioning

confidence: 99%

COPD uncovered: a cross-sectional study to assess the socioeconomic burden of COPD in Japan

Igarashi¹,

Fukuchi²,

Hirata³

et al. 2018

COPD

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BackgroundCOPD remains a major health problem in Japan. Patients with COPD experience a reduced quality of life (QoL) and have a higher chance of work impairment and productivity loss. However, there is a lack of data on the impact of COPD in terms of QoL and work activity impairment in Japan. This study assessed the socioeconomic burden of COPD in Japan and the impact it may have on the working age population.Patients and methodsThis was a 2-year retrospective chart review in COPD patients aged ≥40 years, with at least one health care visit to clinic or hospital in the previous 12 months. Patients were required to have available medical charts for at least the previous 24 months. Symptoms were assessed using COPD assessment test score; EuroQoL Group 5 Dimension (EQ-5D-5L) and work productivity and activity impairment general health questionnaires were used to evaluate health-related QoL and work productivity, and health care resource utilization data were obtained from clinical charts.ResultsIn total, 71 patients aged <65 years, and 151 patients aged ≥65 years were included; the majority of patients had moderate or severe airflow limitation. Exacerbations (moderate or severe) were reported by ~35% of patients in both age groups; 52.1% and 62.9% of patients in the <65-year and ≥65-year age groups had COPD assessment test scores ≥10. EQ-5D-5L index scores in the <65-year and ≥65-year age groups were 0.79 and 0.77, respectively. Work productivity and activity impairment scores were higher in <65-year age group. Annual costs of health care resource use per patient in the <65-year and ≥65-year age groups were ¥438,975 (US$4,389) and ¥467,871 (US$4,678), respectively. Costs due to productivity loss were estimated to be ¥5,287,024 (US$52,870) in the <65-year age group and ¥3,018,974 (US$30,187) in the ≥65-year age group.ConclusionCOPD represents a significant socioeconomic burden in Japan. Patients with COPD report significant use of health care resources. Higher impact on work impairment and productivity loss was observed frequently in the working age population.

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Section: Discussionmentioning

confidence: 99%

COPD uncovered: a cross-sectional study to assess the socioeconomic burden of COPD in Japan

Igarashi¹,

Fukuchi²,

Hirata³

et al. 2018

COPD

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“…Combination therapies, as well as the cost of comorbidity-associated management, are the reasons for the large increase in medication expense in this group of patients [106,107]. Another study estimated the annual per-patient direct costs (including the cost of exacerbations, hospitalisation and pharmaceutical treatment) of COPD to be €2810, 54% of which reflected the management of exacerbations [109]. When indirect (work loss days per year and other productivity losses) and patient time costs were added to direct costs, the total annual burden of COPD in Greece rose sharply to €4730 per patient [109].…”

Section: Economic Burden Of Copd Exacerbations During the Greek Crisismentioning

confidence: 99%

Impact of the financial crisis on COPD burden: Greece as a case study

et al. 2018

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Poverty and low socioeconomic status have been associated with chronic obstructive pulmonary disease (COPD). The current financial crisis has forced millions back into poverty. Greece is one of the countries hit the hardest, and is in the middle of a deep ongoing collapse. There have been early reports stating the apparent effects of the Greek downturn on respiratory health. This review summarises the overall impact of the financial crisis on COPD burden throughout the period of economic downturn by analysing the case study of Greece. In all levels of the healthcare system, current economic restrictions have reduced the capacity to prevent, diagnose and treat COPD in parallel with current higher detection rates of COPD. Remarkably, expenditure on healthcare has been reduced by >25%, resulting in major healthcare equipment shortages. Lower wages (by up to 20%) and higher co-payments of up to 25% of a drug's purchase price have led to patients struggling to afford inhaled medications. Treatment nonadherence has been reported, resulting in 11.5% more exacerbations and 14.1% more hospitalisations annually, while the mean cost per severe COPD exacerbation has been approximated as €2600. Greece is a noteworthy example illustrating how COPD burden, quality of care and patients' outcome can be affected by economic crisis.

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“…In Greece, the only study to have made an estimate of the total cost of COPD is the one of Souliotis et al, 15 which reports that the total cost of COPD in Greece is €4,729.9, of which €2,809.70 was for direct medical costs (€835 for maintenance phase costs and €462.30 for additional resources cost [such as LTOT] while €1,512.40 was for exacerbations costs). However, due to the fact that in this study a different methodology was used (the study was based on expert opinion rather than patient-level data) and different parameters were taken into consideration, it is difficult to compare with the current study.…”

Section: Discussionmentioning

confidence: 99%

“…14 In Greece, there are very few studies – using different methods – estimating the cost of COPD. A recent study reported a total annual per-patient cost of €4,730, 15 while another study focusing on severe exacerbations reported a cost of €1,711 per severe exacerbation. 16 …”

Section: Introductionmentioning

confidence: 99%

The annual direct costs of stable COPD in Greece

Stafyla

Geitona

Kerenidi

et al. 2018

COPD

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IntroductionChronic obstructive pulmonary disease (COPD) places a major burden on health care systems and has substantial economic effects; however, the cost of stable disease in Greece has never been thoroughly explored. The objective of the study was to estimate the annual COPD patient cost during the maintenance phase and explore the relationships between the cost and disease severity.MethodsData were collected from 245 COPD patients (male: 231, mean age: 69.5±8.8 years) who visited the outpatient unit of University Hospital of Larissa in 2014 and 2015. Patients were classified according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, and the patients’ direct cost during the maintenance phase was calculated.ResultsEleven percent of COPD patients were stage I, 48.2% were stage II, 29% were stage III, and 11.8% were stage IV. According to the GOLD groups, 23.3% of patients were grade A, 15.5% were grade B, 22.9% were grade C, and 38.4% were grade D. The mean annual direct cost for stable disease was estimated at €1,034.55 per patient, of which €222.94 corresponded to out-of-pocket payments. The annual cost ranged from €408.23 to €2,041.89 depending on GOLD stages (I–IV) and from €550.01 to €1,480.00 depending on GOLD groups (A–D). The key cost driver was pharmaceutical treatment, which reflected almost 71% of the total expenses for the management of stable disease. The mean annual per-patient cost was two to three times higher for those with advanced disease (stages III–IV) compared to those with stages I–II disease, and it doubled for “high-risk” patients (groups C–D) compared to “low-risk” patients (groups A–B).ConclusionThe cost of COPD during the maintenance phase is remarkable, with the key cost driver found to be pharmaceutical treatment and social insurance funds the key payer for treating COPD patients in Greece. The cost of stable disease is proportional to the severity of COPD, and it is doubled in patients who belong to high-risk groups.

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The direct and indirect costs of managing chronic obstructive pulmonary disease in Greece

Cited by 36 publications

References 12 publications

COPD uncovered: a cross-sectional study to assess the socioeconomic burden of COPD in Japan

COPD uncovered: a cross-sectional study to assess the socioeconomic burden of COPD in Japan

Impact of the financial crisis on COPD burden: Greece as a case study

The annual direct costs of stable COPD in Greece

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