The Burden Of Chronic Obstructive Pulmonary Disease (COPD) In Finland: Impact Of Disease Severity And Eosinophil Count On Healthcare Resource Utilization

Int J Chron Obstruct Pulmon Dis. 2019 Oct 25:14:2409-2421. doi: 10.2147/COPD.S222581. eCollection 2019.

Abstract

Purpose: The burden associated with chronic obstructive pulmonary disease (COPD) is substantial. The objectives of this study were to describe healthcare resource utilization (HCRU) and HCRU-associated costs in patients with COPD in Finland, according to disease severity and blood eosinophil count (BEC).

Patients and methods: This non-interventional, retrospective registry study (GSK ID: HO-17-17558) utilized data from the specialist care hospital register. Data extraction was from first hospital visit with a COPD diagnosis (index date) from January 1, 2004 until December 31, 2015 or death. Patients (aged >18 years with ≥1 report of post-bronchodilation forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio <0.7) were categorized as having non-severe or severe COPD (FEV1 >50% or ≤50% of reference, respectively). Patients who were initially non-severe but progressed to severe were classified as having progressing COPD. Patients without spirometry registry data were classified as having clinically verified COPD. Patients were grouped according to BEC (≥300 cells/μL, <300 cells/μL or BEC unknown). HCRU, estimated associated costs and mortality were evaluated according to COPD severity and BEC.

Results: There were 9042 patients with COPD; 340 non-severe, 326 progressing, 394 severe, and 7982 clinically verified. BEC was available for 31.8% of patients. The mean follow-up time was 3.7-6.5 years in the classified patient-groups. All-cause mortality was 46% during follow-up. Severe COPD was associated with more COPD-related HCRU and higher mortality than non-severe COPD. Patients with BEC ≥300 cells/μL had higher overall HCRU but improved survival compared with those with BEC <300 cells/μL. Overall direct costs were similar across COPD severity categories, 3300-3900€/patient-year, although COPD-related costs were higher in patients with severe versus non-severe COPD.

Conclusion: This study demonstrated a substantial burden associated with severe and/or eosinophilic COPD for patients in Finland.

Keywords: healthcare costs; mortality; prevalence; severe COPD; severe eosinophilic COPD.

MeSH terms

  • Cause of Death
  • Cost of Illness*
  • Disease Progression
  • Eosinophils*
  • Finland / epidemiology
  • Forced Expiratory Volume
  • Health Care Costs*
  • Health Resources / economics*
  • Humans
  • Leukocyte Count
  • Lung / physiopathology*
  • Prevalence
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / economics*
  • Pulmonary Disease, Chronic Obstructive / mortality
  • Pulmonary Disease, Chronic Obstructive / therapy*
  • Registries
  • Retrospective Studies
  • Severity of Illness Index
  • Time Factors
  • Vital Capacity