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Obstructive Lung Diseases |

Economic Impact of Dyspnea and Other Symptoms Among Patients Diagnosed With Chronic Obstructive Pulmonary Disease (COPD) in a Managed Care Setting

Anand Dalal, PhD; Judith Stephenson, MS; Tao Gu, PhD; Debra Wertz, PharmD; Jeetvan Patel, MS
Author and Funding Information

GlaxoSmithKline, Durham, NC


Chest. 2013;144(4_MeetingAbstracts):725A. doi:10.1378/chest.1704298
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Abstract

SESSION TITLE: COPD Treatment Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: Exacerbations are primary cost drivers of chronic obstructive pulmonary disease however, exacerbations occur only in a small subset of patients. Majority of patients experience symptoms such as dyspnea. This study determines the economic burden associated with COPD patients reporting presence of dyspnea.

METHODS: Adults, >40 years, with >2 medical claims with COPD ICD-9-CM code, between 2/01/2010 and 1/31/2011, were identified from the HealthCore Integrated Research Database and invited to participate in a cross-sectional survey. The survey included modified Medical Research Council (mMRC) Dyspnea Scale, COPD Assessment Test (CAT), clinical measures such as smoking status, BMI, spirometry testing in last 6 months and demographic characteristics. Survey data were linked to administrative claims data for 6 months pre and post the survey date. Patients were classified as symptomatic for mMRC grade ≥2 or CAT score >10, consistent with GOLD guidelines. All-cause and COPD-related costs were estimated from generalized linear regression models with log link and gamma distribution.

RESULTS: Of 673 patients with completed surveys and 6-month pre- and post-index claims, 33.1% reported mMRC grade ≥2 and 75.2% reported CAT score >10. Higher all-cause and COPD-related costs and exacerbations were observed in 6-month post-index for symptomatic mMRC and CAT patients compared to asymptomatic patients. mMRC asymptomatic versus symptomatic patients’ adjusted all cause costs were $10,373 versus $11,600 (p=0.359) whereas COPD-related costs per patient were $3,854 versus $5,623 (p=0.025). Exacerbation rates for mMRC asymptomatic versus symptomatic patients were 16.2% versus 15.7% (p<0.001). CAT asymptomatic versus symptomatic patients’ adjusted all-cause costs were $7,672 versus $11,716 (p=0.006) whereas COPD-related costs were $3,289 versus $4,978 (p=0.057). Exacerbation rates for CAT asymptomatic versus symptomatic patients were 1.8% versus 12.1% (p<0.001).

CONCLUSIONS: COPD patients considered symptomatic on either mMRC or CAT scale were associated with increased all-cause and COPD-related costs and exacerbations compared to asymptomatic patients in the 6-month post period after adjusting for baseline differences in proxy measures of severity.

CLINICAL IMPLICATIONS: Better management of COPD symptoms may be associated with cost savings.

DISCLOSURE: Anand Dalal: Employee: GlaxoSmithKline Judith Stephenson: Grant monies (from industry related sources): GlaxoSmithKline funded study Tao Gu: Grant monies (from industry related sources): GlaxoSmithKline funded study Debra Wertz: Grant monies (from industry related sources): GlaxoSmithKline funded Study Jeetvan Patel: Employee: GlaxoSmithKline

No Product/Research Disclosure Information


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