Bronchiectasis and COPD Patients in US Face High Financial Burden, Study Says

Bronchiectasis and COPD Patients in US Face High Financial Burden, Study Says
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The financial burden associated with healthcare costs is relatively high for U.S. patients with chronic obstructive pulmonary disease (COPD) or bronchiectasis, especially for those who are affected by both disorders, a study reports.

The study, “Health-care utilization and expenditures among patients with comorbid bronchiectasis and chronic obstructive pulmonary disease in US clinical practice,” was published in Chronic Respiratory Disease.

Bronchiectasis and COPD are two chronic respiratory diseases that can coexist in a patient, a medical condition known as bronchiectasis-COPD overlap syndrome.

“There is growing recognition that BE [bronchiectasis], either by itself or combined with chronic obstructive pulmonary disease (COPD), represents a growing burden on the U.S. health-care system, which has raised calls for increased surveillance in primary care. The prevalence of COPD within BE is reported to range from 26% to 69%,” the authors wrote.

However, not much is known regarding the financial burden faced by patients with bronchiectasis or bronchiectasis-COPD overlap syndrome living in the U.S.

This retrospective matched-cohort study gathered healthcare data from U.S. patients with bronchiectasis, COPD, or bronchiectasis-COPD overlap syndrome that had been stored at the Truven Health Analytics MarketScan Commercial Claims and Encounters, and Medicare Supplemental and Coordination of Benefits databases between 2009 and 2013.

The total annual rate of healthcare utilization and expenditures for 2013, as well as the annual rate specifically associated with respiratory complications from the same year, were determined for each group of patients.

The study involved a total of 679,679 patients, including 15,573 with bronchiectasis, 648,652 with COPD, and 15,454 with bronchiectasis-COPD overlap syndrome.

On average, the annual rate of healthcare utilization and expenditures among patients with bronchiectasis-COPD overlap syndrome was 2.4 to 3.5 times higher than patients with bronchiectasis, and 2 to 2.5 times higher than those with COPD alone.

The mean number of acute care hospitalizations and ambulatory encounters (outpatient care) were also significantly higher among patients with bronchiectasis-COPD overlap syndrome (0.39 and 16.5, respectively), compared with bronchiectasis patients (0.11 and 6.8, respectively) or COPD alone (0.16 and 8.2, respectively).

The mean annual rate of healthcare utilization and expenditures for any reason was significantly higher for patients with bronchiectasis-COPD overlap syndrome ($44,212) than for those with bronchiectasis ($26,047) or COPD alone ($30,567).

In addition, the mean annual rate of healthcare utilization and expenditures specifically associated with respiratory complications was also significantly higher for patients with bronchiectasis-COPD overlap syndrome ($15,685), than in those with bronchiectasis ($5,605) or COPD alone ($6,262).

“While levels of health-care utilization and expenditures for respiratory-related care (excluding pharmacotherapy) represented 20–30% of all-cause care among patients with BE only and COPD only, the percentage among patients with BE + COPD ranged from 30–46%. Accordingly, relative differences in respiratory-related utilization and expenditures were greater than those for the all-cause measures,” the authors wrote.

According to the researchers, awareness of the financial burden placed on patients who have both bronchiectasis and COPD has a few important implications. First, COPD research should take into account the possibility of bronchiectasis in these patients to avoid confounding results. Second, clinicians should screen for bronchiectasis in COPD patients to prevent undertreatment of the condition.

“Lastly, the large economic burden that these conditions place on the health-care system should be a call-to-action for organizations that promote treatment guidelines,” the researchers concluded.

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