A Real-World Analysis of Patient Cost Burden From COPD and Its Treatment Regimens
Author(s)
John Kim, BS, MHS1, Bruce Miller, PhD2, Mark Luttmann, BS2, Nabin Poudel, PhD1, Jiwon Oh, BS3, Julia F. Slejko, PhD1;
1University of Maryland Baltimore, Practice, Sciences, and Health Outcomes Research, Baltimore, MD, USA, 2COPD Foundation, Miami, FL, USA, 3University of Maryland Baltimore, School of Pharmacy, Baltimore, MD, USA
1University of Maryland Baltimore, Practice, Sciences, and Health Outcomes Research, Baltimore, MD, USA, 2COPD Foundation, Miami, FL, USA, 3University of Maryland Baltimore, School of Pharmacy, Baltimore, MD, USA
OBJECTIVES: While the system-level burden of chronic obstructive pulmonary disease (COPD) has been well characterized, more limited data are available surrounding its economic impact on patients. This research investigates out-of-pocket (OOP) costs of newly diagnosed COPD patients and compares OOP costs across long-term COPD treatment strategies.
METHODS: We identified newly diagnosed COPD patients aged ≥ 35 years using 2016-2022 data from a 25% random sample of IQVIA PharMetrics® Plus for Academics. Patients were grouped into six maintenance therapy regimens (based on GOLD 2024 treatment guidelines: LAMA, LABA, LAMA+LABA, ICS, LABA+ICS, triple therapy) using the earliest 90-day episode of use following diagnosis. All-cause and COPD-specific OOP costs were calculated over the first year following diagnosis and the first year following treatment initiation. Costs were adjusted to mid-year 2024 USD using the medical component of the Consumer Price Index.
RESULTS: Of 11,138 newly diagnosed COPD patients, 2,848 initiated long-term therapy. Patients paid on average $620 for COPD-related expenses in the year following diagnosis, which made up 17% of total annual spendings. Across all service settings, the emergency department had the highest proportion of COPD-specific costs, which accounted for 56% of all ED-related expenses. There were significant differences in OOP costs across therapy regimens. LABA+ICS was the most frequently utilized regimen with the highest all-cause OOP costs ($4,308) and statistically significantly higher outpatient costs than other categories ($1,744, p<0.01). For COPD-specific OOP costs, LABA+ICS remained among one of the costliest treatment strategies alongside triple therapy at $822 and $875 respectively while LABA was the least costly ($558).
CONCLUSIONS: Although current guidelines do not recommend the use of LABA+ICS, it was the most utilized and among the costliest regimens from the patient’s perspective. Aligning treatment decisions with updated guidelines may improve outcomes while also resulting in better cost offsets for patients.
METHODS: We identified newly diagnosed COPD patients aged ≥ 35 years using 2016-2022 data from a 25% random sample of IQVIA PharMetrics® Plus for Academics. Patients were grouped into six maintenance therapy regimens (based on GOLD 2024 treatment guidelines: LAMA, LABA, LAMA+LABA, ICS, LABA+ICS, triple therapy) using the earliest 90-day episode of use following diagnosis. All-cause and COPD-specific OOP costs were calculated over the first year following diagnosis and the first year following treatment initiation. Costs were adjusted to mid-year 2024 USD using the medical component of the Consumer Price Index.
RESULTS: Of 11,138 newly diagnosed COPD patients, 2,848 initiated long-term therapy. Patients paid on average $620 for COPD-related expenses in the year following diagnosis, which made up 17% of total annual spendings. Across all service settings, the emergency department had the highest proportion of COPD-specific costs, which accounted for 56% of all ED-related expenses. There were significant differences in OOP costs across therapy regimens. LABA+ICS was the most frequently utilized regimen with the highest all-cause OOP costs ($4,308) and statistically significantly higher outpatient costs than other categories ($1,744, p<0.01). For COPD-specific OOP costs, LABA+ICS remained among one of the costliest treatment strategies alongside triple therapy at $822 and $875 respectively while LABA was the least costly ($558).
CONCLUSIONS: Although current guidelines do not recommend the use of LABA+ICS, it was the most utilized and among the costliest regimens from the patient’s perspective. Aligning treatment decisions with updated guidelines may improve outcomes while also resulting in better cost offsets for patients.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE260
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)