Economic burden of COPD in a Swedish cohort: the ARCTIC study

Abstract

BackgroundWe assessed direct and indirect costs associated with COPD in Sweden and examined how these costs vary across time, age, and disease stage in a cohort of patients with COPD and matched controls in a real-world, primary care (PC) setting.Patients and methodsData from electronic medical records linked to the mandatory national health registers were collected for COPD patients and a matched reference population in 52 PC centers from 2000 to 2014. Direct health care costs (drug, outpatient or inpatient, PC, both COPD related and not COPD related) and indirect health care costs (loss of income, absenteeism, loss of productivity) were assessed.ResultsA total of 17,479 patients with COPD and 84,514 reference controls were analyzed. During 2013, direct costs were considerably higher among the COPD patient population (€13,179) versus the reference population (€2,716), largely due to hospital nights unrelated to COPD. Direct costs increased with increasing disease severity and increasing age and were driven by higher respiratory drug costs and non-COPD-related hospital nights. Indirect costs (~€28,000 per patient) were the largest economic burden in COPD patients of working age during 2013.ConclusionAs non-COPD-related hospital nights represent the largest direct cost, management of comorbidities in COPD would offer clinical benefits and relieve the financial burden of disease.

Epidemiology of Pulmonary Fibrosis: A Cohort Study Using Healthcare Data in Sweden

“…Following a review of the literature, this is the first study linking the national registers with EMR data to describe the epidemiology of pulmonary fibrosis/IPF in the Swedish population. The method of combining data from EMRs and national registers has been used in numerous previous studies [17][18][19][20][21]. This allows patients to be followed between primary and secondary care settings, and to capture disease epidemiology and healthcare resource utilisation.…”

<p>Modelling the Cost-Effectiveness of Indacaterol/Glycopyrronium versus Salmeterol/Fluticasone Using a Novel Markov Exacerbation-Based Approach</p>

“…Daily drug costs were derived from the Swedish Pharmaceutical Benefits Agency (TLV), while an analysis of economic burden in the ARCTIC study was used to source maintenance and exacerbation costs. 40 A key benefit of using these data is that costs were reported per moderate exacerbation, per severe exacerbation, and per maintenance therapy. Average costs for moderate and severe exacerbations included: COPD-related or -unrelated costs, drug costs, outpatient/inpatient costs, and primary care costs, as well as costs relating to hospitalization in a secondary care center and/or emergency visits for severe exacerbations only, within 14 days after occurrence of an exacerbation event.…”

Diagnosis, Prevention and Treatment of Stable COPD and Acute Exacerbations of COPD: The Swiss Recommendations 2018

“…Direct COPD-related costs increase with disease severity. In Sweden, direct costs from COPD are reported as EUR 7,320 for mild, EUR 8,280 for moderate, EUR 9,230 for severe and EUR 11,810 for very severe disease [18]. Indirect costs such as the inability to work may be affected in individuals with the disease [18].…”

“…In Sweden, direct costs from COPD are reported as EUR 7,320 for mild, EUR 8,280 for moderate, EUR 9,230 for severe and EUR 11,810 for very severe disease [18]. Indirect costs such as the inability to work may be affected in individuals with the disease [18]. In 2012, the average income of a Swedish COPD patient was less than half of what a non-COPD patient earns (EUR 11,500 vs. EUR 29,000 in 2012) [18].…”

“…Indirect costs such as the inability to work may be affected in individuals with the disease [18]. In 2012, the average income of a Swedish COPD patient was less than half of what a non-COPD patient earns (EUR 11,500 vs. EUR 29,000 in 2012) [18].…”