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Pharmacoeconomic Evaluation of COPD
Chest, 2000-11, Vol.118 (5), p.1278-1285
2000
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Autor(en) / Beteiligte
Titel
Pharmacoeconomic Evaluation of COPD
Ist Teil von
  • Chest, 2000-11, Vol.118 (5), p.1278-1285
Ort / Verlag
Northbrook, IL: Elsevier Inc
Erscheinungsjahr
2000
Quelle
MEDLINE
Beschreibungen/Notizen
  • The clinical outcomes and health-carecosts of a cohort of 413 patients with COPD are reported. This study was a retrospective pharmacoeconomicanalysis. University teaching hospital andaffiliated clinics. COPD patients with anFEV1 < 65% of predicted and an FEV1/FVCratio < 70% were eligible to be included in this analysis. Health-care resource utilization and costswere identified through chart review and were stratified according tothe severity of COPD using the American Thoracic Society stages I, II,and III. The pharmacoeconomic analysis was a cost-of-illness evaluationthat included the acquisition costs of initially prescribed pulmonarydrugs, acquisition cost of pulmonary drugs added during the follow-upperiod, oxygen therapy, laboratory and diagnostic test costs, clinicvisit costs, and emergency department and hospital costs. Total treatment cost was highly correlated withdisease severity, with stage I COPD having the lowest cost ($1,681 perpatient per year), stage III COPD having the highest cost ($10,812 perpatient per year), and stage II COPD having a cost intermediate tostage I and stage III ($5,037 per patient per year). With the exceptionof add-on drug acquisition cost, all cost variables were the highest instage III COPD, the lowest in stage I COPD, and intermediate in stageII COPD. Hospitalization was the most important cost variable for allthree stages of COPD severity. When stratified by both disease severityand initial bronchodilator drug selection, ipratropium alone in stage ICOPD patients and the combination of ipratropium plus a β-agonist(with or without steroid therapy) in stage II and stage III COPDpatients had the lowest total costs. Reasons for the lower total costof the ipratropium and ipratropium plus β-agonist treatment groupsincluded lower add-on drug costs, fewer diagnostic and laboratorytests, and a lower utilization rate for clinic visits, emergencydepartment visits, and hospitalizations. Our study demonstrates a strong correlation between disease severityand total treatment cost in COPD. In addition, the type ofbronchodilator therapy impacts total cost in COPD. In stage I COPD,ipratropium alone had the lowest total cost, while in stage II andstage III COPD, a combination of ipratropium plus a β-agonist had thelowest total cost. These data support the concept that adherence topublished treatment guidelines will result in lower health-care costsdue to COPD.

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