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HEALTHCARE AND ECONOMIC BURDEN IN UNDIAGNOSED CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) PATIENTS

GlaxoSmithkline, Research Triangle Park, NC

PURPOSE: To quantify the resource utilization and cost burden in patients in the year prior to their diagnosis with COPD.

METHODS: This retrospective administrative claims analysis compared healthcare utilization and cost in patients with COPD to their counterparts with no COPD for the 12 months prior to the date of COPD diagnosis. COPD patients (identified using ICD9-CM codes) were matched to their counterparts with no COPD based on age, gender, eligibility, geographic region, and index date. Multivariate analysis was employed to determine the incremental impact of undiagnosed COPD on resource utilization and costs. Logistic and negative binomial regressions were used to model the occurrence of all-cause and respiratory-related inpatient and emergency department (ED) visits, and physician office visits. A two part model was employed to assess costs.

RESULTS: A total of 28,968 and 81,322 patients were identified in the COPD and control cohorts, yielding a match ratio of approximately 1:3. The cohorts had similar age, regional and gender distribution as a result of matching. Logistic models produced odds ratios of 5.6 (95 % CI: 5.4 –5.9) and 17.1 (95% CI: 15.4 –19.9) for COPD subjects vs. controls for all-cause and respiratory-related inpatient/ED visits, respectively, indicating a greater likelihood of events in the COPD cohort. Similarly, incidence rate ratios for all-cause and respiratory-related physician office visits were 4.1 (95% CI: 4.0 –4.2) and 7.4 (95% CI: 7.2 –7.7) for COPD patients vs. controls. Based on the two-part model for cost, the predicted total medical cost in the COPD cohort was $6.539.6 compared to $809.9 for non-COPD cohort. Predicted respiratory related medical costs were also substantially higher for COPD cohort compared to non-COPD cohort ($1,703.8 in COPD cohort vs. $64.6 in non-COPD cohort).

CONCLUSION: Undiagnosed COPD patients consume a significant amount of healthcare resources and cost in the 12 months prior to their diagnosis with the condition.

CLINICAL IMPLICATIONS: Early identification of these patients and early intervention may help mitigate some of this healthcare use and cost.

DISCLOSURE: Rohit Borker, Employee GlaxoSmithKline