Healthcare resource utilization in patients with pulmonary hypertension associated with chronic obstructive pulmonary disease (PH-COPD): a real-world data analysis

被引:2
作者
Weiss, Tracey [1 ]
Near, Aimee M. [2 ]
Zhao, Xiaohui [2 ]
Ramey, Dena Rosen [1 ]
Banerji, Tania [2 ]
Xie, Handing [2 ]
Nathan, Steven D. [3 ]
机构
[1] Merck & Co Inc, Ctr Observat & Real World Evidence, 351 N Sumneytown Pike, North Wales, PA 19454 USA
[2] IQVIA, Durham, NC USA
[3] Inova Fairfax Hosp, Adv Lung Dis & Lung Transplant Program, Falls Church, VA USA
关键词
Chronic obstructive pulmonary disease (COPD); Comorbidities; Healthcare cost; Healthcare resource utilization; Hospitalization; Pulmonary hypertension secondary to COPD; EXACERBATION; IMPACT; SCORE;
D O I
10.1186/s12890-023-02698-9
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Rationale There is a lack of real-world characterization of healthcare costs and associated cost drivers in patients with pulmonary hypertension secondary to chronic obstructive pulmonary disease (PH-COPD).Objectives To examine (1) excess healthcare resource utilization (HCRU) and associated costs in patients with PH-COPD compared to COPD patients without PH; and (2) patient characteristics that are associated with higher healthcare costs in patients with PH-COPD.Methods This study analyzed data from the IQVIA PharMetrics (R) Plus database (OCT2014-MAY2020). Patients with PH-COPD were identified by a claims-based algorithm based on PH diagnosis (ICD-10-CM: I27.0, I27.2, I27.20, I27.21, I27.23) after COPD diagnosis. Patients aged >= 40 years and with data available >= 12 months before (baseline) and >= 6 months after (follow-up) the first observed PH diagnosis were included. Patients with other non-asthma chronic pulmonary diseases, PH associated with other causes, cancer, left-sided heart failure (HF), PH before the first observed COPD diagnosis, or right-sided/unspecified HF during baseline were excluded. Patients in the PH-COPD cohort were matched 1:1 to COPD patients without PH based on propensity scores derived from baseline patient characteristics. Annualized all-cause and COPD/PH-related (indicated by a primary diagnosis of COPD or PH) HCRU and costs during follow-up were compared between the matched cohorts. Baseline patient characteristics associated with higher total costs were examined in a generalized linear model in the PH-COPD cohort.Results A total of 2,224 patients with PH-COPD were identified and matched to COPD patients without PH. Patients with PH-COPD had higher all-cause HCRU and annual healthcare costs ($51,435 vs. $18,412, p<0.001) than matched COPD patients without PH. Among patients with PH-COPD, costs were primarily driven by hospitalizations (57%), while COPD/PH-related costs accounted for 13% of all-cause costs. Having a higher comorbidity burden and a prior history of COPD exacerbation were major risk factors for higher total all-cause costs among patients with PH-COPD.Conclusions Treatment strategies focusing on preventing hospitalizations and managing comorbidities may help reduce the burden of PH-COPD.
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