Healthcare costs of the SATisfaction and adherence to COPD treatment (SAT) study follow-up.


Journal

Respiratory medicine
ISSN: 1532-3064
Titre abrégé: Respir Med
Pays: England
ID NLM: 8908438

Informations de publication

Date de publication:
07 2019
Historique:
received: 28 12 2018
revised: 04 05 2019
accepted: 27 05 2019
pubmed: 8 6 2019
medline: 22 7 2020
entrez: 8 6 2019
Statut: ppublish

Résumé

Chronic obstructive pulmonary disease (COPD) is characterised by recurring exacerbations. We estimated the costs of healthcare resources for COPD management funded by the Italian National Healthcare Service (INHS) for one year. We examined the demographic, clinical, and economic variables at enrolment and follow-up visits (at 6 and 12 months) of COPD patients participating in the SAT study and referred to 20 Italian pulmonary centres with different institutional characteristics. Costs were expressed in Euro (€) 2018. A random effects log-linear panel regression model was performed to predict the average cost per patient. Most of the centres were public institutions (90%; public university hospital: 30%). The total average cost of COPD was €2647.38/patient and ICS/LABA/LAMA therapy contributed the most (€1541.45). The average cost was €6206.19/patient for severe COPD (+139.67% vs the cost/patient with mild or moderate COPD). The regression model showed that, others things being equal, increases in the predicted average logged cost per patient were due to liquid oxygen therapy (+468.31%), three COPD exacerbations during the follow-up (+254.54%), and ICS/LABA or ICS/LABA/LAMA associated therapy (+59.26%). Moreover, a 1.19% increment was observed for each additional score of the CAT questionnaire. Conversely, a 36.52% reduction in the predicted average logged cost was reported for hospitals managed by local healthcare authorities. The health econometric approach is innovative in the management of COPD patients in Italy. The results of the random effects log-linear panel data regression model may help clinicians estimate INHS costs when managing COPD patients. Clinicaltrials.gov ID# NCT02689492.

Sections du résumé

BACKGROUND
Chronic obstructive pulmonary disease (COPD) is characterised by recurring exacerbations. We estimated the costs of healthcare resources for COPD management funded by the Italian National Healthcare Service (INHS) for one year.
METHODS
We examined the demographic, clinical, and economic variables at enrolment and follow-up visits (at 6 and 12 months) of COPD patients participating in the SAT study and referred to 20 Italian pulmonary centres with different institutional characteristics. Costs were expressed in Euro (€) 2018. A random effects log-linear panel regression model was performed to predict the average cost per patient.
RESULTS
Most of the centres were public institutions (90%; public university hospital: 30%). The total average cost of COPD was €2647.38/patient and ICS/LABA/LAMA therapy contributed the most (€1541.45). The average cost was €6206.19/patient for severe COPD (+139.67% vs the cost/patient with mild or moderate COPD). The regression model showed that, others things being equal, increases in the predicted average logged cost per patient were due to liquid oxygen therapy (+468.31%), three COPD exacerbations during the follow-up (+254.54%), and ICS/LABA or ICS/LABA/LAMA associated therapy (+59.26%). Moreover, a 1.19% increment was observed for each additional score of the CAT questionnaire. Conversely, a 36.52% reduction in the predicted average logged cost was reported for hospitals managed by local healthcare authorities.
CONCLUSIONS
The health econometric approach is innovative in the management of COPD patients in Italy. The results of the random effects log-linear panel data regression model may help clinicians estimate INHS costs when managing COPD patients. Clinicaltrials.gov ID# NCT02689492.

Identifiants

pubmed: 31174106
pii: S0954-6111(19)30176-3
doi: 10.1016/j.rmed.2019.05.017
pii:
doi:

Substances chimiques

Adrenergic beta-2 Receptor Agonists 0
Bronchodilator Agents 0
Muscarinic Antagonists 0

Banques de données

ClinicalTrials.gov
['NCT02689492']

Types de publication

Clinical Trial Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

68-75

Commentaires et corrections

Type : ErratumIn

Informations de copyright

Copyright © 2019 Elsevier Ltd. All rights reserved.

Auteurs

Angelo G Corsico (AG)

Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy. Electronic address: corsico@unipv.it.

Fulvio Braido (F)

Department of Internal Medicine (Di.M.I.), University of Genoa, Genoa, Italy.

Marco Contoli (M)

Department of Medical Sciences, University of Ferrara, Ferrara, Italy.

Fabiano Di Marco (F)

Department of Biomedical and Clinical Sciences (DIBIC), University of Milan, Milan, Italy.

Paola Rogliani (P)

Respiratory Unit, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy.

Carla Scognamillo (C)

Boehringer-Ingelheim, Milan, Italy.

Irene Olivi (I)

Boehringer-Ingelheim, Milan, Italy.

Pierachille Santus (P)

Department of Health Sciences, University of Milan, Milan, Italy.

Nicola Scichilone (N)

DIBIMIS, University of Palermo, Palermo, Italy.

Carlo Lazzaro (C)

Studio di Economia Sanitaria, Milan, Italy.

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Classifications MeSH