The Burden Of Chronic Obstructive Pulmonary Disease (COPD) In Finland: Impact Of Disease Severity And Eosinophil Count On Healthcare Resource Utilization
Received 9 July 2019
Accepted for publication 23 September 2019
Published 25 October 2019 Volume 2019:14 Pages 2409—2421
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Cristina Weinberg
Peer reviewer comments 3
Editor who approved publication: Dr Richard Russell
Arja Viinanen,1,2,* Mariann I Lassenius,3,* Iiro Toppila,3 Antti Karlsson,4,5 Lauri Veijalainen,6 Juhana J Idänpään-Heikkilä,6 Tarja Laitinen1,2,7
1Division of Medicine, Department of Pulmonary Diseases, Turku University Hospital, Turku, Finland; 2Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland; 3Medaffcon Oy, Espoo, Finland; 4Auria Biobank, Turku University Hospital, Turku, Finland; 5University of Turku, Turku, Finland; 6GSK, Espoo, Finland; 7Tampere University Hospital, Tampere, Finland
*These authors contributed equally to this work
Correspondence: Arja Viinanen
Division of Medicine, Department of Pulmonary Diseases, Turku University Hospital, Turku FI-20014, Finland
Tel +358 23133319
Purpose: The burden associated with chronic obstructive pulmonary disease (COPD) is substantial. The objectives of this study were to describe healthcare resource utilization (HCRU) and HCRU-associated costs in patients with COPD in Finland, according to disease severity and blood eosinophil count (BEC).
Patients and methods: This non-interventional, retrospective registry study (GSK ID: HO-17-17558) utilized data from the specialist care hospital register. Data extraction was from first hospital visit with a COPD diagnosis (index date) from January 1, 2004 until December 31, 2015 or death. Patients (aged >18 years with ≥1 report of post-bronchodilation forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio <0.7) were categorized as having non-severe or severe COPD (FEV1 >50% or ≤50% of reference, respectively). Patients who were initially non-severe but progressed to severe were classified as having progressing COPD. Patients without spirometry registry data were classified as having clinically verified COPD. Patients were grouped according to BEC (≥300 cells/μL, <300 cells/μL or BEC unknown). HCRU, estimated associated costs and mortality were evaluated according to COPD severity and BEC.
Results: There were 9042 patients with COPD; 340 non-severe, 326 progressing, 394 severe, and 7982 clinically verified. BEC was available for 31.8% of patients. The mean follow-up time was 3.7–6.5 years in the classified patient-groups. All-cause mortality was 46% during follow-up. Severe COPD was associated with more COPD-related HCRU and higher mortality than non-severe COPD. Patients with BEC ≥300 cells/μL had higher overall HCRU but improved survival compared with those with BEC <300 cells/μL. Overall direct costs were similar across COPD severity categories, 3300–3900€/patient-year, although COPD-related costs were higher in patients with severe versus non-severe COPD.
Conclusion: This study demonstrated a substantial burden associated with severe and/or eosinophilic COPD for patients in Finland.
Keywords: severe COPD, severe eosinophilic COPD, prevalence, healthcare costs, mortality
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]