Healthcare Resource Utilization and Costs in Patients Experiencing Severe Cardiac Events Following a COPD Exacerbation: Results from EXACOS-CV Studies in Spain, Germany, the Netherlands and Canada


Parsekar K1, Kossack N2, Hernández I3, Vogelmeier CF4, Kolb N5, Baak B6, Swart-Polinder KMA6, Simons S7, Bengtsson C8, Vojinovic-Dees D9, Sin D10, Hawkins N10, McMullen S11, Pham T11, Corregidor García C12, Martinez N12, Sánchez-Covisa Hernández J12, Abram M13, Halbach M13, van Burk L14, Randhawa A15, Nordon C1
1AstraZeneca, Cambridge, UK, 2WIG2 GmbH, Leipzig, SN, Germany, 3Atrys Health, Madrid, Spain, 4Philipps University of Marburg, Marburg, Germany, 5ZEG – Berlin Center for Epidemiology and Health Research, Berlin, Germany, 6PHARMO Institute for Drug Outcomes Research, Utrecht, Netherlands, 7Maastricht University Medical Centre, Maastricht, Netherlands, 8IQVIA, Solna, Sweden, 9IQVIA, The Netherlands, Netherlands, 10University of British Columbia, Vancouver, BC, Canada, 11Medlior Health Outcomes Research, Calgary, AB, Canada, 12AstraZeneca, Madrid, Spain, 13AstraZeneca, Hamburg, Germany, 14AstraZeneca, Den Haag, Netherlands, 15AstraZeneca, Mississauga, ON, Canada

OBJECTIVES: To describe cardiovascular (CV) hospitalizations and estimate related costs in patients who experienced a severe CV event following an exacerbation of Chronic Obstructive Pulmonary Disease (ECOPD).

METHODS: EXACOS-CV program is a set of observational cohort studies. This analysis includes patients with COPD from Canada, Germany, Spain, the Netherlands (NL), identified in secondary databases between 2014-2018. For the present analyses we selected patients who had (hospitalization for acute coronary syndrome, heart failure, stroke or arrhythmias, or death) and an ECOPD within 12 months preceding it. CV-related, respiratory-related and all-cause hospitalizations were described during the 12 months pre-outcome and the 1-3 and 3-12 months post-outcome. The respective across-country cost per capita of hospitalizations were computed in the 12-month prior and 12-month post-outcome.

RESULTS: 43,546 patients were included. In the 12 months pre-outcome, between 23% (Germany) and 44% (NL) of patients already had 1+ CV-related hospitalization. Immediately post-outcome (0-1 month), 32% (Spain), 48% (the NL), 50% (Germany), and 69% (Canada) of patients were no longer in the cohort (attrition primarily due to death). Attrition reached up to 72% at 3-12 months post-outcome (Canada). In the 1-3 months post-outcome, CV-related re-hospitalizations were observed in 3% (Spain) to 21% (Germany) of patients. In the 3-12 months post-outcome, these rates ranged between 10% (Spain) and 32% (NL). The average cost of CV hospitalizations doubled over 12 months post-outcome (€12,551, range: €3582 – €27,394) compared to prior-outcome (€5,010, range: €671 – €10,340) due to both outcome-related hospitalization and re-hospitalizations. Similar trends were seen for all-cause and COPD-related hospitalizations.

CONCLUSIONS: Severe CV events increase HCRU and costs in exacerbating COPD patients namely due to cardiac re-hospitalizations, highlighting the economic burden incurred by increased cardiopulmonary risk in COPD and the urgency for comprehensive clinical management.

Conference/Value in Health Info

2023-11, ISPOR Europe 2023, Copenhagen, Denmark

Value in Health, Volume 26, Issue 11, S2 (December 2023)




Real World Data & Information Systems, Study Approaches

Topic Subcategory

Electronic Medical & Health Records, Health & Insurance Records Systems


Cardiovascular Disorders (including MI, Stroke, Circulatory), Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)

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