title: The pharmacological cost of COPD during Greek economic crisis.
abstract: BACKGROUND
  The economic crisis in Greece has substantially affected patients with COPD. The reduction of disposable income has its consequences on patients' ability to afford their medication. The aim of the study is to evaluate the cost of treatment for patients with COPD and the influence of the financial crisis to the patients.
  
  
  METHODS
  Data were collected from 189 patients (male: 178, mean age: 70.1±8.4) who visited the outpatient department of University Hospital of Larissa in 2014 and 2015. The pharmacological cost of treatment was calculated based on national pharmaceutical formulary prices.
  
  
  RESULTS
  COPD patients were classified into four stages according to Global Initiative for Chronic Obstructive Lung Disease (GOLD): 7.4% were in stage I, 43.4% in stage II, 34.4% in stage III, and 14.8% in stage IV. Patients were graded as per GOLD as follows: 18% as grade A, 14.3% as B, 23.3% as C, and 44.4% as D. The annual cost of COPD maintenance treatment per patient was €952.92 (±398.01), of which €239.91 were patients' expenses. The annual treatment cost for stable disease ranged from €615.44 to €1302.03 depending on disease stages (GOLD stages I-IV) and from €715.01 to €1101.05 depending on GOLD grades (grades A-D). The cost of maintenance medication was statistically and significantly higher for patients with advanced disease (GOLD stages III-IV) and for patients at high risk (GOLD grades C-D [P=0.000]).
  
  
  CONCLUSIONS
  The pharmacological cost of treatment for COPD patients seems to be considerably high, in all disease stages. As the average income is decreased, patients face difficulties to afford inhaled medication.
authors.affiliation: Respiratory Medicine Department, University of Thessaly School of Medicine, University Hospital of Larissa, Larissa.
authors.forename: Eirini
authors.initials: E
authors.lastname: Stafyla
authors.affiliation: Respiratory Medicine Department, University of Thessaly School of Medicine, University Hospital of Larissa, Larissa.
authors.forename: Theodora
authors.initials: T
authors.lastname: Kerenidi
authors.affiliation: Respiratory Medicine Department, University of Thessaly School of Medicine, University Hospital of Larissa, Larissa.
authors.forename: Irini
authors.initials: I
authors.lastname: Gerogianni
authors.affiliation: Department of Social Policy, University of Peloponnese, Korithos, Greece.
authors.forename: Mary
authors.initials: M
authors.lastname: Geitona
authors.affiliation: Respiratory Medicine Department, University of Thessaly School of Medicine, University Hospital of Larissa, Larissa.
authors.forename: Zoe
authors.initials: Z
authors.lastname: Daniil
authors.affiliation: Respiratory Medicine Department, University of Thessaly School of Medicine, University Hospital of Larissa, Larissa.
authors.forename: Konstantinos I
authors.initials: KI
authors.lastname: Gourgoulianis
mesh_terms: D000280:Administration, Inhalation; D000368:Aged; D001993:Bronchodilator Agents / Q000008:administration & dosage* / Q000191:economics*; D016527:Drug Costs; D057172:Economic Recession; D005260:Female; D005382:Financing, Personal; D005541:Forced Expiratory Volume; D006115:Greece; D005102:Health Expenditures; D006785:Hospitals, University / Q000191:economics; D006801:Humans; D007182:Income; D008168:Lung / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics* / Q000503:physiopathology; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014797:Vital Capacity
chemical_list: D001993:Bronchodilator Agents
keywords: COPD; economic crisis; maintenance treatment; pharmacological cost