title: Trend of cost and utilization of COPD medication in Korea.
abstract: BACKGROUND
  There are only a few longitudinal studies regarding medical utilization and costs for patients with COPD. The purpose of this study was to analyze the trend of medical utilization and costs on a long-term basis.
  
  
  METHODS
  Using the Korean Health Insurance Review and Assessment Service (HIRA) data from 2008 to 2013, COPD patients were identified. The trend of medical utilization and costs was also analyzed.
  
  
  RESULTS
  The number of COPD patients increased by 13.9% from 2008 to 2013. During the same period, the cost of COPD medication increased by 78.2%. Methylxanthine and systemic beta agonists were most widely prescribed between 2008 and 2013. However, inhaled medications such as long-acting beta-2 agonist (LABA), long-acting muscarinic agonist, and inhaled corticosteroid plus LABA were dispensed to a relatively low proportion of patients with COPD. The number of patients who were prescribed inhaled medications increased gradually from 2008 to 2013, while the number of patients prescribed systemic beta agonist and methylxanthine has decreased since 2010.
  
  
  CONCLUSIONS
  This study shows that there is a large gap between the COPD guidelines and clinical practice in Korea. Training programs for primary care physicians on diagnosis and guideline-based treatment are needed to improve the management of COPD.
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul.
authors.forename: Jongmin
authors.initials: J
authors.lastname: Lee
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul.
authors.forename: Jae Ha
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Pharmaceutical Policy Evaluation Research Team, Research Institution, Health Insurance Review and Assessment Service, Wonju-si, Republic of Korea.
authors.forename: Jee-Ae
authors.initials: JA
authors.lastname: Kim
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul.
authors.forename: Chin Kook
authors.initials: CK
authors.lastname: Rhee
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000191:economics; D058666:Adrenergic beta-2 Receptor Agonists / Q000008:administration & dosage / Q000191:economics; D001993:Bronchodilator Agents / Q000008:administration & dosage* / Q000191:economics*; D016208:Databases, Factual; D004338:Drug Combinations; D016527:Drug Costs / Q000639:trends*; D011307:Drug Prescriptions / Q000191:economics; D019983:Guideline Adherence; D006295:Health Resources / Q000191:economics* / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D018727:Muscarinic Antagonists / Q000008:administration & dosage / Q000191:economics; D058988:Phosphodiesterase 4 Inhibitors / Q000008:administration & dosage / Q000191:economics; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000191:economics* / Q000639:trends*; D000071836:Professional Practice Gaps / Q000191:economics / Q000639:trends; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology; D056910:Republic of Korea / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D058666:Adrenergic beta-2 Receptor Agonists; D001993:Bronchodilator Agents; D004338:Drug Combinations; D018727:Muscarinic Antagonists; D058988:Phosphodiesterase 4 Inhibitors
keywords: chronic obstructive; drug prescriptions; medical cost; medical utilization; pulmonary disease