Abstract:test, Wilcoxon test, Chi-square test) were: number of patients exposed to allogeneic red cells, amount of blood transfusions, and the number of length of stay in hospital. An economic model was quantified the cost saving of EVICEL® in ICH. Results: preliminary results showed that application of EVICEL reduce number of transfused RBC, postoperative haemoglobin loss, and days of hospital stay. In the hospital cost. analysis EVICEL® predicts resource reduction with average cost-savings of € 1.227 per patient. Con… Show more
“…Another study by Zacherle et al using US claims data also found significantly more inpatient visits in AATD patients compared to COPD patients without AATD (58% vs. 19.5%) leading to an increase by $US27,674 in total healthcare costs per patient [ 34 ]. However, this study included the AT costs of AT-receiving AATD patients (13% in the sample) and was not adjusted for differences in COPD severity.…”
Section: Discussionmentioning
confidence: 99%
“…In COSYCONET, indirect costs did not show significant differences between COPD patients with and without AATD. However, Zacherle et al found COPD patients without AATD to receive disability benefits twice as often as AATD patients (40.1% vs. 20.3%, p < 0.001) [ 34 ]. To the knowledge of the authors, the present study is the first one comparing indirect costs in COPD patients with and without AATD in a comprehensive manner.…”
BackgroundAlpha-1-Antitrypsin Deficiency (AATD) is an economically unexplored genetic disease.MethodsDirect and indirect costs (based on self-reported information on healthcare utilization) and health-related quality of life (HRQL, as assessed by SGRQ, CAT, and EQ-5D-3 L) were compared between 131 AATD patients (106 with, 25 without augmentation therapy (AT)) and 2,049 COPD patients without AATD participating in the COSYCONET COPD cohort. The medication costs of AT were excluded from all analyses to reveal differences associated with morbidity profiles. The association of AATD (with/without AT) with costs or HRQL was examined using generalized linear regression modelling (GLM) adjusting for age, sex, GOLD grade, BMI, smoking status, education and comorbidities.ResultsAdjusted mean direct annual costs were €6,099 in AATD patients without AT, €7,117 in AATD patients with AT (excluding costs for AT), and €7,460 in COPD patients without AATD. AATD with AT was significantly associated with higher outpatient (+273%) but lower inpatient (−35%) and medication costs (−10%, disregarding AT) compared with COPD patients without AATD. There were no significant differences between groups regarding indirect costs and HRQL.ConclusionApart from AT costs, AATD patients tended to have lower, though not significant, overall costs and similar HRQL compared to COPD patients without AATD. AT was not associated with lower costs or higher HRQL.Trial registration
NCT01245933
Electronic supplementary materialThe online version of this article (doi:10.1186/s12931-017-0543-8) contains supplementary material, which is available to authorized users.
“…Another study by Zacherle et al using US claims data also found significantly more inpatient visits in AATD patients compared to COPD patients without AATD (58% vs. 19.5%) leading to an increase by $US27,674 in total healthcare costs per patient [ 34 ]. However, this study included the AT costs of AT-receiving AATD patients (13% in the sample) and was not adjusted for differences in COPD severity.…”
Section: Discussionmentioning
confidence: 99%
“…In COSYCONET, indirect costs did not show significant differences between COPD patients with and without AATD. However, Zacherle et al found COPD patients without AATD to receive disability benefits twice as often as AATD patients (40.1% vs. 20.3%, p < 0.001) [ 34 ]. To the knowledge of the authors, the present study is the first one comparing indirect costs in COPD patients with and without AATD in a comprehensive manner.…”
BackgroundAlpha-1-Antitrypsin Deficiency (AATD) is an economically unexplored genetic disease.MethodsDirect and indirect costs (based on self-reported information on healthcare utilization) and health-related quality of life (HRQL, as assessed by SGRQ, CAT, and EQ-5D-3 L) were compared between 131 AATD patients (106 with, 25 without augmentation therapy (AT)) and 2,049 COPD patients without AATD participating in the COSYCONET COPD cohort. The medication costs of AT were excluded from all analyses to reveal differences associated with morbidity profiles. The association of AATD (with/without AT) with costs or HRQL was examined using generalized linear regression modelling (GLM) adjusting for age, sex, GOLD grade, BMI, smoking status, education and comorbidities.ResultsAdjusted mean direct annual costs were €6,099 in AATD patients without AT, €7,117 in AATD patients with AT (excluding costs for AT), and €7,460 in COPD patients without AATD. AATD with AT was significantly associated with higher outpatient (+273%) but lower inpatient (−35%) and medication costs (−10%, disregarding AT) compared with COPD patients without AATD. There were no significant differences between groups regarding indirect costs and HRQL.ConclusionApart from AT costs, AATD patients tended to have lower, though not significant, overall costs and similar HRQL compared to COPD patients without AATD. AT was not associated with lower costs or higher HRQL.Trial registration
NCT01245933
Electronic supplementary materialThe online version of this article (doi:10.1186/s12931-017-0543-8) contains supplementary material, which is available to authorized users.
“…A severe clinical course of AATD can lead to increased healthcare resource use (HRU) and healthcare costs [15][16][17]. In a retrospective study examining HRU among Medicare beneficiaries, higher percentages of patients diagnosed with AATD compared with COPD visited the emergency room (ER; 58.4% vs. 42.5%) and had inpatient visits (58.0% vs. 19.5%) [17]. Additionally, total healthcare costs were higher for AATD than COPD by $27,674 per patient [17].…”
Section: Introductionmentioning
confidence: 99%
“…The American Thoracic Society/European Respiratory Society and the Chronic Obstructive Pulmonary Disease Foundation recommend augmentation therapy with a1-protease inhibitors (PIs) or nonspecific therapy for the treatment of some individuals with AATD-associated pulmonary issues [19,20]. Published reports indicate that roughly 13% of patients with AATD receive augmentation therapy [16,17], signaling that it may be underutilized.…”
Pulmonary events (PEs) associated with alpha-1 antitrypsin deficiency (AATD) can have a severe clinical course and increase healthcare resource use (HRU). However, AATD-associated HRU and healthcare costs have not been extensively described. This study describes and compares realworld HRU and healthcare costs among US patients with severe (requiring hospitalization after AATD-related PE) versus nonsevere AATD clinical course. Administrative healthcare claims for patients with a second primary AATD diagnosis between 6/1/2008 and 12/31/2017 were analyzed from 2 databases (requiring continuous enrollment 6 months preceding diagnosis). Patient baseline characteristics and AATD-associated PE incidence rates, HRU, and healthcare costs during follow-up were compared in patients with severe versus nonsevere AATD. Of 5109 patients with a second AATD diagnosis, 2674 (severe, n ¼ 711 [26.6%]; nonsevere, n ¼ 1963 [73.4%]) had !1 AATD-associated PE. PE incidence per 100 person-years was higher in patients with severe versus nonsevere AATD. Annual incidences (mean ± SD) of emergency department (1.2 ± 5.7 vs. 0.4 ± 1.2), inpatient (1.3 ± 2.5 vs. 0.1 ± 0.5), and outpatient (10.3 ± 15.9 vs. 5.7 ± 13.2) visits were higher in patients with severe versus nonsevere AATD. Median (interquartile range) annual costs were also higher for patients with severe versus nonsevere AATD for emergency department ($185
“…While emphysema is the most common pulmonary manifestation in AATD, bronchitis, asthma, and bronchiectasis phenotypes of COPD also occur. AATD-associated COPD presents at a younger age compared to usual COPD, likely because of the enhanced susceptibility to effects of tobacco smoke, dusts, and fumes 3. Other conditions associated with AATD include cirrhosis, hepatocellular carcinoma, necrotizing panniculitis, and granulomatosis with polyangiitis.Figure 1The impact of depression and anxiety in COPD.…”
Chronic physical illness is associated with significant vulnerability for emotional disorders. Some studies suggest anxiety and depression are common comorbidities in individuals with alpha-1 antitrypsin deficiency (AATD). Many aspects of AATD contribute to quality of life impairment. Delays in diagnosis, high costs of disease treatment, and inherited genetic risk add to the symptom burden of lung or liver disease to alter quality of life. Whether anxiety and depression independently contribute to quality of life impairment remains unproven. In this article, we aim to review current literature examining the impact of anxiety and depression on the quality of life of AATD-affected individuals. Multifaceted approaches may best meet the needs of a heterogeneous population and are the best future strategies to minimize these emotional impacts and assure highest quality of life possible. More research studies are needed to achieve this ambitious goal and make life of AATD-affected individuals better by minimizing the effects of anxiety and depression.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
