Burden of Disease Among Exacerbating Patients with COPD Treated with Triple Therapy in Spain

• Main Authors: Alcázar-Navarrete B, García-Rio F, Sánchez G, Mariscal E, García A, Cuesta M, Uría E, Miravitlles M
• Format: Article
• Language: English
• Published: Dove Medical Press 2021-07-01
• Series: International Journal of COPD
• Subjects: frequent exacerbation; triple therapy; cost; eosinophil; health care resources; copd
• Online Access: https://www.dovepress.com/burden-of-disease-among-exacerbating-patients-with-copd-treated-with-t-peer-reviewed-fulltext-article-COPD

Bernardino Alcázar-Navarrete,1,2 Francisco García-Rio,2,3 Guadalupe Sánchez,4 Esther Mariscal,5 Andrea García,5 Maribel Cuesta,6 Estefany Uría,6 Marc Miravitlles2,7 1Respiratory Department. Hospital Universitario Virgen de las Nieves, Granada, Spain; 2CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain; 3Hospital Universitario La Paz, IdiPAZ, Madrid, Spain; 4Medical Department, GSK, Madrid, Spain; 5Market Access Department, GSK, Madrid, Spain; 6Oblikue Consulting, Barcelona, Spain; 7Pneumology Department, Hospital Universitari Vall d’Hebron, Vall D’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Barcelona, SpainCorrespondence: Francisco García-RioHospital Universitario La Paz, Idipaz, Paseo de la Castellana, 261, Madrid, 28046, SpainTel [phone]Email [e-mail]: The cost of chronic obstructive pulmonary disease (COPD) in Spain has been studied from different perspectives, but parameters such as the patient’s phenotype have seldom been considered. Our aim was to describe the disease burden of COPD patients with frequent exacerbator phenotype, treated with triple therapy.Methods: An observational, multicenter study was carried out from December 2017 to November 2018 in pulmonology services among patients ≥ 40 years with COPD confirmed diagnosis receiving triple therapy (ICS/LAMA/LABA) and history of ≥ 2 moderate or ≥ 1 severe exacerbation in the 12 months prior to the inclusion visit. COPD-related healthcare resources were collected over a 12-months period prior to the inclusion visit: pharmacological and non-pharmacological treatments, medical and ER visits, hospitalizations, tests and productivity loss. Costs were updated to € 2019. Patients were classified according to blood eosinophil levels: < 150 cells/μL and ≥ 150 cells/μL.Results: A total of 306 patients were included (77.1% men), with mean age of 69.9 years. Mean COPD exacerbation rate was 2.5/patient/year and 51.3% of patients had ≥ 150 cells/μL eosinophil level. On average, for the total population, COPD-related visits/patients/year were 6.2. Resource use in moderate exacerbation was higher in patients with eosinophils ≥ 150 cells/μL, whereas in severe exacerbation was higher in patients with eosinophils < 150cells/μL. According to eosinophil levels, total annual mean (SD) costs/patient accounted for € 8382 (9863) and € 5144 (5444) for patients with eosinophils < 150 cells/μL and ≥ 150 cells/μL, respectively.Conclusion: The impact of exacerbating COPD patients treated with triple therapy in Spain is large, especially among those with eosinophils < 150 cells/μL.Keywords: frequent exacerbation, triple therapy, cost, eosinophil, health care resources, COPD