title: Costs of illness analysis in Italian patients with chronic obstructive pulmonary disease (COPD): an update.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality worldwide, and its epidemiological, clinical, and socioeconomic impact is progressively increasing. A first estimate of the economic burden of COPD in Italy was conducted in 2008 (the SIRIO [Social Impact of Respiratory Integrated Outcomes] study). The aim of the present study is to provide an updated picture of the COPD economic burden in Italy.
  
  
  METHODS
  Sequential patients presenting at the specialist center for the first time during the period 2008-2012 and with record file complete (demographic, clinical, lung function, and therapeutic data; health care resources consumed in the 12 months before the enrollment and for the 3 subsequent years) were selected from the institutional database.
  
  
  RESULTS
  Two hundred and seventy-five COPD patients fitting the inclusion criteria were selected (226 males; mean age: 70.9 years [standard deviation: ±8.4 years]; 45.8% were from the north, 25.1% from central Italy, and 29.1% from south Italy). COPD-related average costs per patient in the 12 months before enrollment were as follows: hospitalization: €1,970; outpatient care: €463; pharmaceutical: €499; and indirect costs: €358. Average direct costs and total societal costs were €2,932 and €3,291, respectively. Direct cost was €2,461 (hospitalization: €1,570; outpatient: €344; and pharmaceutical: €547) in the first year of follow-up, while total societal cost was €2,707. No significant difference was reported in any cost category between sexes.
  
  
  CONCLUSIONS
  The therapeutic approach followed in a specialist center, based on the application of clinical guidelines, has been shown to be a highly effective investment for the long-term management of COPD. A small increase of pharmaceutical costs per year allowed a substantial saving in terms of hospitalizations, costs related to outpatient services, and indirect costs.
authors.affiliation: National Center for Respiratory Pharmacoeconomics and Pharmacoepidemiology, Verona, Italy ; Research and Clinical Governance, Verona, Italy.
authors.forename: Roberto W
authors.initials: RW
authors.lastname: Dal Negro
authors.affiliation: National Center for Respiratory Pharmacoeconomics and Pharmacoepidemiology, Verona, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Bonadiman
authors.affiliation: Research and Clinical Governance, Verona, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Turco
authors.affiliation: General Hospital, ULSS 22 Regione Veneto, Bussolengo, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Tognella
authors.affiliation: SIHS Health Economics Consulting, Torino, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Iannazzo
keywords: COPD; health costs; pharmacoeconomic; sex dependency
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