Chronic treatment of COPD: state of the art and real-world analysis of healthcare costs based on medication adherence data.

Chronic Obstructive Pulmonary Disease (COPD), represents a serious and growing health problem worldwide. Healthcare should be conceived and structured in a proactive logic mode predicting to promote prevention and supporting the patient in the path of care. This desirable approach could reduce the impact of chronicity on patient' quality of life and health care costs. In this context, the theme of therapeutic adherence represents one of the priorities on which to intervene. To show a real life picture of the health expenditure and economics consequences due to non-adherent COPD therapy. Patients with a COPD diagnosis were selected from the Regional Health Information System Edotto; consumption data was also obtained from the same patients and was based on data relating to prescriptions dispensed by affiliated pharmacies belonging to the Local Health Agency of the province of Barletta-Andria-Trani (LHA BT) in a time period including 2017 and 2018. The assisted patients not adhering to COPD treatment (medication possession ratio between 20% and 80%) in 2017 were included in the analysis. The system Edotto was used to verify how many of them had become adherent in 2018. For both groups of patients, the average cost per patient was assessed, both in terms of pharmaceutical expenditure and hospitalizations due to COPD. Of the 66 patients not adhering to the treatment in 2017, 66.67% (44 patients) became adherent to therapy and 33.33% (22 patients) remained non-adherent to treatment during 2018. The total cost (pharmaceutical expenditure ATC-R03 and the cost derived from hospitalizations due to COPD) for non-adherent patient during 2018 was 73% increase compared to the cost of the patient adhering to treatment (p=.000317), thus resulting a saving of € 992.56 per adherent patient. Adherence to COPD therapy can improve patient health and reduce healthcare costs.