scholarly journals The Budget Impact of Duoresp® Spiromax® (Budesonide + Formoterol Fumarate Dihydrate) Compared With Symbicort® Turbohaler® for the Management of Asthma and Chronic Obstructive Pulmonary Disease in the United Kingdom: Impact on Health Care Costs and Inhalation Technique

2014 ◽  
Vol 17 (7) ◽  
pp. A591
Author(s):  
A. Lewis ◽  
M. Blackney ◽  
S. Torvinen ◽  
J. Holmes ◽  
M. Osborne ◽  
...  
2018 ◽  
Author(s):  
Ralph Turner ◽  
Michael DePietro ◽  
Bo Ding

BACKGROUND Although asthma and chronic obstructive pulmonary disease (COPD) are clinically distinct diseases, they represent biologically diverse and overlapping clinical entities and it has been observed that they often co-occur. Some research and theorizing suggest there is a common comorbid condition termed asthma-chronic obstructive pulmonary disease overlap (ACO). However, the existence of ACO is controversial. OBJECTIVE The objective of this study is to describe patient characteristics and estimate prevalence, health care utilization, and costs of ACO using claims-based diagnoses confirmed with medical record information. METHODS Eligible patients were commercial US health plan enrollees; ≥40 years; had asthma, COPD, or ACO; ≥3 prescription fills for asthma/COPD medications; and ≥2 spirometry tests. Records for a random sample of 5000 patients with ACO were reviewed to validate claims-based diagnoses. RESULTS The estimated ACO prevalence was 6% (estimated 10,250/183,521) among 183,521 full study patients. In the claims-based cohorts, the comorbidity burden for ACO was greater versus asthma but similar to COPD cohorts. Medication utilization was higher in ACO versus asthma and COPD. Mean total health care costs were significantly higher for ACO versus asthma but similar to COPD. In confirmed diagnoses cohorts, mean total health care costs (medical plus pharmacy) were lower for ACO versus COPD but similar to asthma (US $20,035; P=.56). Among confirmed cases, where there was medical record evidence, smoking history was higher in ACO (300/343, 87.5%) versus asthma cohorts (100/181, 55.2%) but similar to COPD (68/84, 81%). CONCLUSIONS ACO had more comorbidities, medication utilization, and costs than patients with asthma or COPD but differences were not seen after confirmation with medical records.


2019 ◽  
Vol 42 (6) ◽  
pp. 423-430 ◽  
Author(s):  
Wendy S. Bauer ◽  
Rachel F. Schiffman

Individuals with chronic obstructive pulmonary disease (COPD) struggle with effective self-management, contributing to poor health outcomes and costly health care. More research is needed to understand the factors influencing COPD self-management better in order to improve outcomes and reduce health care costs for those living with this prevalent chronic illness. The purpose of this article is to describe factors influencing community-dwelling adults’ COPD self-management. In-depth interviews were conducted with 28 people living with COPD. Braun and Clarke’s thematic analysis approach was used to analyze interview data, and it resulted in the identification of themes providing insight into COPD self-management as described by those living with the disease. Specifically, factors impacting engagement in treatment recommendations are described. These findings have implications for informing evidence-based recommendations for self-management support and improving the quality of care provided to those with COPD.


2018 ◽  
Author(s):  
Wanrudee Isaranuwatchai ◽  
Olwen Redwood ◽  
Adrian Schauer ◽  
Tim Van Meer ◽  
Jonathan Vallée ◽  
...  

BACKGROUND Exacerbation of chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) are associated with high health care costs owing to increased emergency room (ER) visits and hospitalizations. Remote patient monitoring (RPM) interventions aim to improve the monitoring of symptoms to detect early deterioration and provide self-management strategies. As a result, RPM aims to reduce health resource utilization. To date, studies have inconsistently reported the benefits of RPM in chronic illnesses. The Smart Program is an RPM intervention that aims to provide clinical benefit to patients and economic benefit to health care payers. OBJECTIVE This study aims to economically evaluate the potential benefits of the Smart Program in terms of hospitalizations and ER visits and, thus, associated health care costs from the perspective of the public health care system. METHODS Seventy-four patients diagnosed with COPD or CHF from one hospital site were included in this one-group, pre-post study. The study involved a secondary data analysis of deidentified data collected during the study period – from 3 months before program initiation (baseline), during the program, to 3 months after program completion (follow-up). Descriptive analysis was conducted for the study population characteristics at baseline, the clinical frailty score at baseline and 3-month follow-up, client satisfaction at 3-month follow-up, and number and costs of ER visits and hospitalizations throughout the study period. Furthermore, the cost of the Smart Program over a 3-month period was calculated from the perspective of the potential implementer. RESULTS The baseline characteristics of the study population (N=74) showed that the majority of patients had COPD (50/74, 68%), were female (42/74, 57%), and had an average age of 72 (SD 12) years. Using the Wilcoxon signed-rank test, the number of ER visits and hospitalizations, including their associated costs, were significantly reduced between baseline and 3-month follow-up (P<.001). The intervention showed a potential 68% and 35% reduction in ER visits and hospitalizations, respectively, between the 3-month pre- and 3-month postintervention period. The average cost of ER visits reduced from Can $243 at baseline to Can $67 during the 3-month follow-up, and reduced from Can $3842 to Can $1399 for hospitalizations. CONCLUSIONS In this study, the number and cost of ER visits and hospitalizations appeared to be markedly reduced for patients with COPD or CHF when comparing data before and after the Smart Program implementation. Recognizing the limitations of the one-group, pre-post study design, RPM requires an upfront investment, but it has the potential to reduce health care costs to the system over time. This study represents another piece of evidence to support the potential value of RPM among patients with COPD or CHF.


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