PRS23 - a descriptive analysis of patient characteristics and health care burden associated with chronic obstructive pulmonary disease in the us medicare population

Abstract

Objectives: To evaluate the patient characteristics and health care burden associated with chronic obstructive pulmonary disease (COPD) in the U.S. Medicarepopulation. Methods: COPD patients were identified (International Classificationof Disease, 9th Revision, Clinical Modification [ICD-9-CM] codes: 491.xx, 492.xx and496.xx) using U.S. national Medicare claims from 01JAN2007 to 31DEC2010. The firstdiagnosis date was designated as the index date. Patients were required to: a) be age?65 years on the index date; b) have continuous medical and pharmacy benefits for 12months pre-index date (baseline period); c) have continuous enrollment for 12 monthspost-index date (follow-up period), unless there was earlier evidence of death; and d)have no COPD diagnosis pre-index date. The outcomes of interest included medicationuse, including a long-acting beta agonist (LABA) or LABA/inhaled corticosteroid (ICS)combination, mortality and health care resource utilization and costs. Results: Atotal of 543,249 COPD patients were identified. Patients were, on average, age 78 years.Most patients were white (94%) and resided in the South U.S. region (41%). The averageCharlson Comorbidity Index score was 3.23, and hypertension (67%), diabetes (28%),congestive heart failure (21%) and chronic pulmonary disease (20%) were the mostfrequently diagnosed comorbidities. A 13.82% mortality rate was observed duringthe first year of the follow-up period. Post-index LABA medications, including arfomoterol (0.55%), formoterol (0.25%) and salmeterol (0.32%) were prescribed to 1.10%of the population. Identified LABA/ICS combinations included budesonide/formoterol(1.97%) and fluticasone/salmeterol (10.02%). High health care resource utilization wasencountered for Medicare carrier (99.40%), pharmacy (90.27%), outpatient (76.52%)and inpatient visits (48.83%). The main cost drivers were inpatient ($10,645), Medicarecarrier ($4,888), outpatient ($3,322) and skilled nursing facility ($2,695) costs, resultingin $25,397 in total health care costs. Conclusions: U.S. Medicare patients have ahigh COPD-related health care burden