Economic burden of comorbidities among COPD Patients hospitalized for acute exacerbations: an analysis of a commercially insured population

ABSTRACT

Introduction

This study quantifies costs associated with comorbid conditions among adults diagnosed with chronic obstructive pulmonary disease (COPD) who experience acute exacerbations (AECOPD) needing inpatient hospitalization.

Methods

This retrospective cohort study used 2006–2015 IQVIA PharMetrics® Plus data, a health plan claims database. Patients aged 40–64 years, with AECOPD, defined as an inpatient hospitalization for a COPD-related diagnosis were included. The impact of comorbidities on AECOPD costs (costs of the COPD-related inpatient stay plus healthcare services used 30 days post-discharge) was determined using multivariable regression. The models adjusted for clinical complications, previous utilization, age, sex, region, year, length of hospitalization, and season of admission.

Results

Among these COPD patients, 89.5% had at least 1 comorbidity. The mean cost for AECOPD was 2015 US $19,687 (SD: 27,035, median: 11,539). Congestive heart failure, lipid disorders, cancer, and presence of any of the 10 most frequent comorbidities were associated with $1,921 (95% confidence interval (CI): 977–2,866), $1,619 (95% CI: 967–2,272), $8,347 (95% CI: 7,236–9,458), and $4,433 (95% CI: 3,598–5,268) higher costs, respectively than corresponding individuals without these comorbid conditions. Patients with depressive disorders were associated with $1,592 (95% CI: 828–2,355) lower costs compared to those without depressive disorders.

Conclusion

COPD comorbidity imposes a significant economic burden on AECOPD.

KEYWORDS:

• Chronic obstructive pulmonary disease
• acute exacerbations
• costs
• comorbidity

Acknowledgments

The statements, findings, conclusions, views, and opinions contained and expressed in this manuscript are based in part on data obtained under license from IQVIA. Source: IQVIA PharMetrics® Plus, January 2006 – December 2015. All Rights Reserved. The statements, findings, conclusions, views, and opinions contained and expressed herein are not necessarily those of IQVIA or any of its affiliated or subsidiary entities.

Declaration of interest

Authors declare no conflict of interests.

E Onukwugha reports grants from BeiGene Ltd., grants from Pfizer, Inc., outside this submitted work. Z Zafari reports receiving funding from the US FDA, Maryland Department of Transportation, Maryland Department of Education, and the NIH. The funding is not related to this work. E Villalonga-Olives reports receiving funding from the MCERSI, the Patient Engagement, Diversity and Health Literacy MISP at Merck and NIH. She is also consulting for the Center for Medical Technology Policy. The funding is not related to this work. JF Slejko reports receiving consulting fees from Boehringer Ingelheim pharmaceuticals and funding from PhRMA and PhRMA Foundation for research on COPD unrelated to this publication. She also serves on the COPD Foundation COPD360Net Steering Committee in a volunteer role. 

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. 

Financial Support

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

CS developed the idea, designed the analytical model, performed statistical analyses and wrote the first version of the manuscript. JFS and OE helped develop the research idea, provided supervision and helped with writing the first version of the manuscript. ZZ, EVO, and JEP provided methodological insights. All authors contributed to the manuscript writing and development.

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

This manuscript was not funded.