An economic analysis of pharmacological treatment of COPD in Spain.
BACKGROUND
COPD is a prevalent disease that generates high use of resources. The objective of this study was to quantify the economic consequences of non-adherence to GOLD guidelines for the management of COPD patients.


METHODS
An economic model was generated to compare different scenarios of observed vs. expected costs of COPD treatment. A pooled analysis of data derived from a systematic review of studies describing treatment of COPD in Spain was combined with drug costs (using different assumptions) to obtain the observed cost of COPD treatment. An expected cost was obtained with the minimum and maximum treatment intensity derived from the GOLD recommendations.


RESULTS
A total of 8 studies were identified, comprising 6339 patients. Average medication cost of COPD patients was estimated as being between euro 1218 and euro 1314 per patient per year, higher than the ideal expected average cost (between euro 1007 and euro 1021 per patient/year). Thus, implementation of guidelines would result in a mean reduction of euro 198-euro 293 per patient/year. Sensitivity analysis showed that about 13% of patients had higher treatment costs than the maximum expected cost. This proportion is much higher in moderately/severely affected patients than in mildly affected patients (28.0% and 11.1%, respectively).


CONCLUSIONS
Treatment of COPD allows for the identification of areas of inefficiency. An improvement in the adherence to the GOLD guidelines would imply potential savings of medication costs of about 20% of the observed costs.
Miravitlles
Marc
M
Servei de Pneumologia, Institut Clínic del Tòrax (IDIBAPS), Ciber de Enfermedades Respiratorias (CIBERES), Hospital Clínic, Barcelona, Spain. marcm@clinic.ub.es
Brosa
Max
M
Velasco
María
M
Crespo
Carlos
C
Gobartt
Elena
E
Diaz
Silvia
S
González-Rojas
Nuria
N
D016527:Drug Costs / Q000706:statistics & numerical data*; D019983:Guideline Adherence; D006801:Humans; D018803:Models, Economic; D015337:Multicenter Studies as Topic; D017410:Practice Guidelines as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy / Q000191:economics*; D013030:Spain