Pharmacoeconomic Evaluation of Acute Exacerbations of Chronic Bronchitis and COPD

Miravitlles, Marc; Murio, Cristina; Guerrero, Tina; Gisbert, Ramon

doi:10.1378/chest.121.5.1449

Cited by 254 publications

(191 citation statements)

References 22 publications

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“…Each year, on average, up to one-third of patients with COPD experience one or more exacerbations [62], which represent a major cause of primary care visits, hospital admission, impaired health status and mortality [63,64]. In addition, acute exacerbations account for a substantial percentage of the cost of treating COPD [65]. As such, reduction of these events has become a major goal in the development of new therapeutic strategies for COPD.…”

Section: Copdmentioning

confidence: 99%

Long-term macrolide treatment for chronic respiratory disease

2012

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Long-term macrolide treatment was first shown to alter the natural history of diffuse panbronchiolitis (DPB) in the late 1980s. Since then, macrolides have been demonstrated to exert antiinflammatory and immunomodulatory activity in addition to being antimicrobial. Indeed, their spectrum of action extends to the regulation of leukocyte function and production of inflammatory mediators, control of mucus hypersecretion, resolution of inflammation and modulation of host defence mechanisms. As such, the potential benefit of macrolide antibiotics has been evaluated in a variety of chronic respiratory diseases. The best studied condition is cystic fibrosis, of which there have been six randomised controlled trials showing evidence of benefit. However, most of the studies were limited by small numbers of patients and short follow-up. More recently, landmark studies have demonstrated the efficacy of azithromycin in reducing the risk of acute exacerbations in patients with chronic obstructive pulmonary disease, but the optimal duration and dosing of macrolide treatment remain uncertain.With the exception of patients with DPB and cystic fibrosis, until clear evidence of efficacy is available, the long-term use of macrolides should be limited to highly selected patients after careful evaluation of benefit and harm, or in the context of randomised controlled clinical trials. @ERSpublications Several studies evaluating macrolide antibiotics for the treatment of chronic respiratory diseases are underway

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Section: Copdmentioning

confidence: 99%

Long-term macrolide treatment for chronic respiratory disease

2012

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“…1 The economic impact of COPD varies widely and causes an enormous health problem for the patients and their families, the work place, health institutions and society as a whole. 2,3 Exacerbations and hospitalizations due to COPD constitute the most important direct health care costs associated with COPD. 4 The cost of COPD treatment and the quality of life of the patients is greatly influenced by the severity of the disease and the drugs used in its management.…”

Section: Introductionmentioning

confidence: 99%

Impact of Severity of the Disease on Cost of Illness and Quality of Life of Patients with Chronic Obstructive Pulmonary Disease

Kallaru¹,

Nagasubramanian²,

Balakrishnan³

et al. 2015

JYP

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Objective: The objective of the study was to assess the cost of illness of COPD and the influence of severity of the disease over cost of illness and the quality of life. Materials and Methods: The study was conducted in 105 patients aged > 40 years and <70 years, diagnosed with stages II, III and IV COPD. Cost of illness (direct and indirect costs) was calculated in Indian rupees from the expenditures of the hospital visits, pharmacotherapy, oxygen therapy, biochemical investigations, diagnostic procedures, physiotherapy and hospitalization due to acute exacerbations by patient interview and review of patient's case history, medical and billing records. Quality of life of 50 patients in Stage III and Stage IV COPD was estimated using St. George's Respiratory Questionnaire (SGRQ) score. Results: The mean cost spent by the patients with stage II COPD was Rs.3179.62 ± 99.01 per visit to the hospital, stage III was Rs.16414.79 ± 8365.79 and stage IV was Rs.44077.16 ± 15686.21 per visit. As the severity of COPD increased both direct and indirect costs increased and the quality of life of the patient decreased significantly (P=0.000). Out of the total costs, highest was spent on direct medical costs (81.2%). Direct nonmedical costs contributed to 10.6% and indirect costs to 8%. The drivers of the total cost were found to be hospitalizations (36.2%) and length of stay. Conclusion: Since acute exacerbations are the main cause of hospitalization among COPD patients, strategies to prevent severe exacerbations could be very cost effective and may improve the quality of life.

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“…Pharmacological therapy accounts for a substantial part of the resources used in the long-term management of these patients [8], increasing with disease severity [9] and especially during acute exacerbations of COPD (AECOPD) [10]. However, nonpharmacological treatments have gained in popularity as an essential part of therapy, to promote self-efficacy and relieve symptoms.…”

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confidence: 99%

Nonpharmacological treatment and relief of symptoms in COPD: Table 1—

Clini

Ambrosino²

2008

Eur Respir J

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Evidence-based guidelines for chronic obstructive pulmonary disease (COPD) have recently been developed.Nonpharmacological treatments have evolved rapidly as an essential part of COPD therapy. They are especially important as complementary interventions in severe or very severe disease, when there is loss in function, a reduction in quality of life and when psychological impairments further complicate the disease.The present article discusses the most used nonpharmacological treatments for severe COPD patients (rehabilitation, long-term oxygen therapy, surgery, noninvasive positive pressure ventilation and supportive nutrition) and their evidence-based usefulness in promoting strategies that relieve symptoms.All of these interventions are used during end-stage disease, to promote self-efficacy, relieve symptoms and prevent further deterioration. These therapeutic options support physicians and allied professionals in improving symptom management for their patients.

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Pharmacoeconomic Evaluation of Acute Exacerbations of Chronic Bronchitis and COPD

Cited by 254 publications

References 22 publications

Long-term macrolide treatment for chronic respiratory disease

Long-term macrolide treatment for chronic respiratory disease

Impact of Severity of the Disease on Cost of Illness and Quality of Life of Patients with Chronic Obstructive Pulmonary Disease

Nonpharmacological treatment and relief of symptoms in COPD: Table 1—

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