Trends in health care resource utilization and pharmacological management of COPD in Taiwan from 2004 to 2010

Abstract

RationaleCOPD has attracted widespread attention worldwide. The prevalence of COPD in Taiwan has been reported, but little is known about trends in health care resource utilization and pharmacologic management in COPD treatment.ObjectiveThe objective of this article was to study trends in health care resource utilization, pharmacologic management, and medical costs of COPD treatment in Taiwan.Materials and methodsReimbursement claims in the Taiwan National Health Insurance System from 2004 to 2010 were collected. The disease burden of COPD, including health care resource utilization and medical costs, was evaluated.ResultsThe pharmacy cost of COPD increased from 2004 to 2010 due to the increased utilization of long-acting muscarinic antagonist (LAMA) and fixed-dose combination of long-acting β2-agonist and inhaled corticosteroid (LABA/ICS), whereas the cost of all other COPD-related medications decreased. The average outpatient department (OPD) cost per patient increased 29.3% from 1,070 USD in 2004 to 1,383 USD in 2010. The highest average total medical cost per patient was 3,434 USD in 2005, and it decreased 12.4% to 3,008 USD in 2010. There was no significant difference in the average number of OPD visits and emergency department visits per patient. The highest average number of hospital admissions was 0.81 in 2005, and it decreased to 0.65 in 2010. The average number of intensive care unit (ICU) admissions decreased from 0.52 in 2005 to 0.31 in 2010.ConclusionFrom 2004 to 2010, the average total medical cost per patient of COPD was slightly decreased because of the decreased average number of hospital admissions and ICU admissions. The costs of both LAMA and LABA/ICS increased, while the cost for all other COPD-related medications decreased. These findings suggest that the increased utilization of LAMA and LABA/ICS may have contributed to the decreased average number of hospital admissions and ICU admissions in COPD patients from 2004 to 2010.

Statin use and Vital Organ Failure in Patients With Asthma–Chronic Obstructive Pulmonary Disease Overlap: A Time-Dependent Population-Based Study

“…Furthermore, ICS and OS formula may attenuate the risk of hepatic, renal, and heart failure. In agreement with our result, Tsai et al discovered that the ICS formula was associated with the lowest frequency of ICU admission based on the NHIRD (Tsai et al, 2017). Statin use in the early course of ACO may attenuate these risks in the later course of this disease.…”

End-of-Life Health Care Utilization Between Chronic Obstructive Pulmonary Disease and Lung Cancer Patients

“…Tsai et al found that the average number of hospital and ICU admissions mainly affected the average total medical cost at the end of life in COPD patients. 42 In particular, a hospital admission for a COPD exacerbation episode that requires intensive care represents a significant milestone that may merit advanced care planning and may be an opportunity to initiate communication on end-of-life care. The care model should consider the specific cost trend of COPD and integrate palliative care during the lifelong disease trajectory.…”

Direct and indirect costs of COPD progression and its comorbidities in a structured disease management program: results from the LQ-DMP study

“…Contrarily Tsai et al [32] found a 12.4% decrease of direct costs from US$3434 in 2004 to US$3008 in 2010 in Taiwan, mainly attributable to decreased average numbers of hospital and intensive care unit admissions. Also for the US Nurmagambetov et al [33] measured direct costs for COPD in a working age patients and found a decline in expenditures from US$1400 in 1999 to US$960 in 2003 in varying populations, which is mainly attributable to a reduction in hospital admissions.…”