HEALTHCARE RESOURCE USE OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) EXACERBATIONS: A RETROSPECTIVE ANALYSIS OF GERMAN CLAIMS DATA
Author(s)
Kai-Michael Beeh, MD1, Kathrin Kahnert, MD2, Nils Picker, PhD3, Sabine Bartel, PhD4, Nikola Jovanoski, PhD5, Katerina Samara, MD, PhD5, Parul Dayal, MS, PhD6, Johannes Ammann, PhD5.
1INSAF Institut für Atemwegsforschung GmbH, Taunusstein, Germany, 2Department of Internal Medicine V, University of Munich, Comprehensive Pneumology Centre, Munich, Germany; MediCenterGermering, Germering, Germany, 3GIPAM GmbH, Wismar, Germany, 4Roche Pharma AG, Grenzach-Wyhlen, Germany, 5F. Hoffmann-La Roche Ltd, Basel, Switzerland, 6Genentech Inc., South San Francisco, CA, USA.
1INSAF Institut für Atemwegsforschung GmbH, Taunusstein, Germany, 2Department of Internal Medicine V, University of Munich, Comprehensive Pneumology Centre, Munich, Germany; MediCenterGermering, Germering, Germany, 3GIPAM GmbH, Wismar, Germany, 4Roche Pharma AG, Grenzach-Wyhlen, Germany, 5F. Hoffmann-La Roche Ltd, Basel, Switzerland, 6Genentech Inc., South San Francisco, CA, USA.
OBJECTIVES: Data are limited on the economic burden and healthcare resource utilisation (HCRU) of COPD, particularly exacerbations. This study examined real-world data on HCRU associated with COPD exacerbations.
METHODS: Patients (≥40 years) entering GOLD E status (2025 definition) from January 2020-June 2024 were included from an anonymised German statutory health insurance dataset (GWQ ServicePlus). Acute care costs were assessed ≤30 days of moderate or severe exacerbations, defined by acute respiratory deterioration and outpatient corticosteroid prescription, or hospitalisation claims, respectively. Furthermore, outcomes such as recurrent severe exacerbations, mortality, healthcare costs, and prescribed medications were assessed.
RESULTS: 15,285 patients were included with 6,371 moderate exacerbations (3,298 first, 1,338 second and 700 third events) and 18,626 severe exacerbations (13,415 first, 3,459 second and 1,124 third events) during follow-up (median follow-up, 11.6 months). Acute cost per exacerbation (for 1-3 events) was €198-€236 (moderate exacerbations) and €9,202-€9,790 (severe exacerbations). Inpatient care accounted for 99% of acute costs for severe exacerbations. Median length of inpatient stay was 7 days. Following the GOLD E-defining exacerbation, therapy escalation was only performed in 19.8%, 23.4%, 27.0% and 32.1% of patients at 3, 6, 12 and 24 months, respectively. Risk of subsequent severe exacerbation increased with the number of prior severe events: compared with one prior severe event, adjusted hazard ratios (95% confidence intervals) were 1.96 (1.83-2.11), 2.91 (2.61-3.24) and 4.76 (4.13-5.49) for 2, 3 or ≥4 prior severe events, respectively. A similar pattern was seen for all-cause mortality (2.77 [2.48-3.10]; 4.66 [3.89-5.58]; 6.57 [5.15-8.37]) and cumulative acute healthcare cost (adjusted cost ratio: 1.51 [1.35-1.68]; 1.91 [1.63-2.24]; 1.97 [1.66-2.40]) for 2, 3 or ≥4 prior severe exacerbations, respectively.
CONCLUSIONS: Severe exacerbations drive HCRU and mortality. Timely and effective treatment interventions are needed to reduce severe exacerbation risk, associated costs and mortality.
METHODS: Patients (≥40 years) entering GOLD E status (2025 definition) from January 2020-June 2024 were included from an anonymised German statutory health insurance dataset (GWQ ServicePlus). Acute care costs were assessed ≤30 days of moderate or severe exacerbations, defined by acute respiratory deterioration and outpatient corticosteroid prescription, or hospitalisation claims, respectively. Furthermore, outcomes such as recurrent severe exacerbations, mortality, healthcare costs, and prescribed medications were assessed.
RESULTS: 15,285 patients were included with 6,371 moderate exacerbations (3,298 first, 1,338 second and 700 third events) and 18,626 severe exacerbations (13,415 first, 3,459 second and 1,124 third events) during follow-up (median follow-up, 11.6 months). Acute cost per exacerbation (for 1-3 events) was €198-€236 (moderate exacerbations) and €9,202-€9,790 (severe exacerbations). Inpatient care accounted for 99% of acute costs for severe exacerbations. Median length of inpatient stay was 7 days. Following the GOLD E-defining exacerbation, therapy escalation was only performed in 19.8%, 23.4%, 27.0% and 32.1% of patients at 3, 6, 12 and 24 months, respectively. Risk of subsequent severe exacerbation increased with the number of prior severe events: compared with one prior severe event, adjusted hazard ratios (95% confidence intervals) were 1.96 (1.83-2.11), 2.91 (2.61-3.24) and 4.76 (4.13-5.49) for 2, 3 or ≥4 prior severe events, respectively. A similar pattern was seen for all-cause mortality (2.77 [2.48-3.10]; 4.66 [3.89-5.58]; 6.57 [5.15-8.37]) and cumulative acute healthcare cost (adjusted cost ratio: 1.51 [1.35-1.68]; 1.91 [1.63-2.24]; 1.97 [1.66-2.40]) for 2, 3 or ≥4 prior severe exacerbations, respectively.
CONCLUSIONS: Severe exacerbations drive HCRU and mortality. Timely and effective treatment interventions are needed to reduce severe exacerbation risk, associated costs and mortality.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE729
Topic
Clinical Outcomes, Economic Evaluation, Epidemiology & Public Health
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)