Healthcare Resource Consumption of Patients with Chronic Obstructive Pulmonary Disease Treated with Triple and Dual Therapy and Experiencing an Acute Exacerbation
Author(s)
Calabria S1, Ronconi G2, Dondi L2, Dondi L2, Piccinni C2, Dell'Anno I2, Pedrini A2, Esposito I3, Brignoli O4, Canonica GW5, Carone M6, Di Marco F7, Micheletto C8, Vancheri C9, Martini N2
1Fondazione Ricerca e Salute (ReS), Casalecchio di Reno, BO, Italy, 2Fondazione Ricerca e Salute (ReS), Rome, Italy, 3Drugs & Health srl, Rome, Italy, 4Italian College of General Practitioners and Primary Care, Florence, Italy, 5Humanitas University & Research Hospital-IRCCS, Milan, Italy, 6Istituti Clinici Scientifici Maugeri IRCCS, Bari, Italy, 7Università degli Studi di Milano, Milan, Italy, 8Verona University Hospital, Verona, Italy, 9Catania University Hospital, Catania, Italy
Presentation Documents
OBJECTIVES: Assess the healthcare resource consumption of patients with chronic obstructive pulmonary disease (COPD) treated with triple (TT) and dual (DT) therapy following an acute exacerbation (AECOPD), from the Italian National Health Service (INHS)’s perspective.
METHODS: From Fondazione Ricerca e Salute’s database (administrative healthcare data of ~5 million inhabitants/year), patients aged ≥45 with a COPD diagnosis in 2019 were selected. Patients with ≥1 COPD-related treatment supply (index date) were categorized into fixed/open TT and DT and characterized by comorbidities and AECOPDs within 12 months before/after index date. Within one-year follow-up, hospitalizations, in-hospital mortality, local outpatient spirometry, blood gas analysis (BGA) and pneumological examinations, and costs reimbursed by the INHS were assessed for patients switching from DT to TT (DT-TT) and those still treated with DT (DT-DT) after an AECOPD.
RESULTS: Of 105,282 COPD patients (43.1/1000 inhabitants aged ≥45), 3,622 (3.4%) received fixed TT, 21,754 (20.7%) open TT, 37,795 (35.9%) DT, and 34,705 (33.0%) another treatment regimen. More than 90% of TT-treated patients had ≥1 comorbidity (vs 83% DT and 89% another regimen). A previous AECOPD occurred among 42.8% (10,872/25,376) and 30.8% (11,625/37,795) of TT-treated and DT-treated patients, respectively: 28.7% of TT-treated patients (3,121/10,872) came from DT, and 61.7% (6,711/10,872) remained DT-treated. Among DT-TT patients: 34.6% (1,079/3,121) were hospitalized (vs 21.1% of DT-DT patients; 1,416/6,711); 0.8% (24/3,121) deceased due to COPD-related causes (vs 0.4%; 28/6,711); 38.2% (1,191/3,121), 33.3% (1,039/3,121) and 21.8% (608/3,121) received ≥1 pneumological examination, BGA, spirometry test, respectively (vs 19.8%, 14.4% and 13.5%). The INHS mean annual total cost was € 5491 per each DT-TT patient and € 3776 per DT-DT patient. Up to 60% of treated patients experienced a further AECOPD.
CONCLUSIONS: This study shows that TT-treated patients were more compromised and accessed INHS resources more frequently than DT-treated patients. Spirometry use was low for both.
Conference/Value in Health Info
Value in Health, Volume 26, Issue 11, S2 (December 2023)
Code
EPH200
Topic
Study Approaches
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)