OBJECTIVES

: Chronic obstructive pulmonary disease (COPD) is a long term, progressive disease. Maintenance medication, especially bronchodilators, are necessary to improve symptoms, and reduce exacerbation events. With the progression of COPD, patients often need to adjust the type of bronchodilator, or use multiple types. COPD brings a heavy economic burden to the patients’ families, and society. This burden only increases at every stage of disease severity. Therefore, to provide a clearer understanding of COPD burden, this paper aims to characterize demographics, comorbidities, and medical resources in COPD patients with different maintenance medication.

METHODS

: Medical records from 4 hospitals between 2011 to 2019 were extracted. A descriptive analysis of distribution for patient demographics and comorbidities (cardiovascular disease, asthma, diabetes and pulmonary hypertension) was analyzed. Also, annual inpatient visits, exacerbation events, and medical costs per patient were calculated. All analysis was categorized by four groups: short-acting bronchodilator/antimuscarinics (SABA/SAMA), long-acting muscarinic antagonists (LAMA), combination of inhaled corticosteroids and long-acting β2-agonist (LABA-ICS) and triple therapy (ICS/LABA/LAMA).

RESULTS

: 1963 SABA/SAMA, 581 LAMA, 2687, LABA-ICS and 686 triple therapy patients were included. Cardiovascular disease was the most frequent comorbidity among all groups. Asthma was more common in LABA-ICS and triple therapy patients (29.18% and 21.28%). Diabetes occurred similarly across groups, with pulmonary hypertension comorbidity the least in all groups. Average annual inpatient visits, and exacerbation events were increasing sequentially in LAMA, LABA-ICS, triple therapy, and SABA/SAMA patients (0.73/0.88/1.23/1.4 and 0.99/1.07/1.3/1.54 visit, respectively). Comparing to LAMA and LABA-ICS groups, median annual medical costs increased dramatically in triple therapy and SABA/SAMA groups (￥1713.98 and ￥1912.74 versus ￥7245.65 and ￥23688.74).

CONCLUSIONS

: Overall, patients with more severe COPD tended to use multiple bronchodilators or combined with inhaled corticosteroids. Moreover, SABA/SAMA were more often used for exacerbation events, and elder patients, which result in higher healthcare costs.