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The direct and indirect costs of managing chronic obstructive pulmonary disease in Greece

Authors Souliotis K, Kousoulakou H, Hillas G, Tzanakis N, Toumbis M, Vassilakopoulos T

Received 20 January 2017

Accepted for publication 9 March 2017

Published 10 May 2017 Volume 2017:12 Pages 1395—1400

DOI https://doi.org/10.2147/COPD.S132825

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Professor Hsiao-Chi Chuang

Peer reviewer comments 2

Editor who approved publication: Dr Richard Russell

Kyriakos Souliotis,1 Hara Kousoulakou,1 Georgios Hillas,2 Nikos Tzanakis,3 Michalis Toumbis,4 Theodoros Vassilakopoulos2

1Department of Social and Educational Policy, University of Peloponnese, Corinth, 2Department of Pulmonary and Critical Care Medicine, Evangelismos Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, 3Department of Thoracic Medicine, Medical School, University General Hospital of Heraklion, Heraklion, Crete, 4Sixth Pulmonary Department, “Sotiria” Hospital for Thoracic Diseases, Athens, Greece

Objective: COPD is associated with significant economic burden. The objective of this study was to explore the direct and indirect costs associated with COPD and identify the key cost drivers of disease management in Greece.
Methods: A Delphi panel of Greek pulmonologists was conducted, which aimed at eliciting local COPD treatment patterns and resource use. Resource use was translated into costs using official health insurance tariffs and Diagnosis-Related Groups (DRGs). In addition, absenteeism and caregiver’s costs were recorded in order to quantify indirect COPD costs.
Results: The total costs of managing COPD per patient per year were estimated at €4,730, with direct (medical and nonmedical) and indirect costs accounting for 62.5% and 37.5%, respectively. COPD exacerbations were responsible for 32% of total costs (€1,512). Key exacerbation-related cost drivers were hospitalization (€830) and intensive care unit (ICU) admission costs (€454), jointly accounting for 85% of total exacerbation costs. Annual maintenance phase costs were estimated at €835, with pharmaceutical treatment accounting for 77% (€639.9). Patient time costs were estimated at €146 per year. The average number of sick days per year was estimated at 16.9, resulting in productivity losses of €968. Caregiver’s costs were estimated at €806 per year.
Conclusion:
The management of COPD in Greece is associated with intensive resource use and significant economic burden. Exacerbations and productivity losses are the key cost drivers. Cost containment policies should focus on prioritizing treatments that increase patient compliance as these can lead to reduction of exacerbations, longer maintenance phases, and thus lower costs.

Keywords: COPD, burden, direct cost, indirect cost, Greece

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