The morbidity and mortality associated with chronic obstructive pulmonary disease (COPD) exacts a considerable economic burden. Comorbidities in COPD are associated with poor health outcomes and increased costs. Our objective was to assess the impact of comorbidities on COPD-associated costs in a large administrative claims dataset.
This was a retrospective observational study of data from the Truven Health MarketScan Commercial Claims and Encounters and MarketScan Medicare Supplemental Databases from January 1, 2009, to September 30, 2012. Resource consumption was measured from the index date (date of first occurrence of non–rule-out COPD diagnosis) to 360 days after the index date. Resource utilization (all-cause and disease-specific [ie, COPD- or asthma-related] emergency room [ER] visits, hospitalizations, office visits, other outpatient visits, and total length of hospital stay) and healthcare costs (all-cause and disease-specific costs for ER visits, hospitalizations, office visits, other outpatient visits, and medical, prescription, and total healthcare costs) were assessed. Generalized linear models were used to evaluate the impact of comorbidities on total healthcare costs, adjusting for age, sex, geographic location, baseline healthcare utilization, employment status, and index COPD medication.
Among 183,681 COPD patients, the most common comorbidities were cardiovascular disease (34.8%), diabetes (22.8%), asthma (14.7%), and anemia (14.2%). Most patients (52.8%) had 1 or 2 comorbidities of interest. The average all-cause total healthcare costs from the index date to 360 days after the index date were highest for patients with chronic kidney disease ($41,288) and anemia ($38,870). The impact on total healthcare costs was greatest for anemia ($10,762 more on average than a patient with COPD without anemia).
Our analysis demonstrated that high resource utilization and costs were associated with COPD and multiple comorbidities.