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COPD: Economical and Surrogate Outcomes—The Case of COPD

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Textbook of Pulmonary Rehabilitation

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Abstract

We will discuss the overall economics in pulmonary rehabilitation by taking chronic obstructive pulmonary disease (COPD) as a model because it is the most prevalent and incident chronic respiratory pathology [1, 2] in both western and developing countries [3] which is provided by a large and consolidated literature. What is available specifically for pulmonary rehabilitation will be addressed in a devoted sub-section. In general, all countries, even those characterized by evolved health models, took their first operational steps quite recently in the field of the “respiratory chronicity”, and of COPD in particular.

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References

  1. Murray CJ, Lopez AD. Alternative projections of mortalità and disability by cause 1990–2020—Global Burden of Disease Study. Lancet. 1997;349:1498–504.

    Article  CAS  PubMed  Google Scholar 

  2. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (Updated February 2013), 2013. Available from: http://www.goldcopd.org/Guidelines/guidelines-global-strategy-for-diagnosis-management-2013.html Accessed December 10, 2014

  3. Yack D, Hawkes C, Gould CL, Hofman KJ. The global Burden of chronic diseases. Overcoming impediments of prevention and control. JAMA. 2004;291(21)

    Google Scholar 

  4. Mathers CD, Loncar D. Projections of global mortality and Burden of disease from 2002 to 2030. PLoS Med. 2006;3(11):e442.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Mannino DM, Higuchi K, Yu TC, Zhou H, Li Y, Tian H, Suh K. Economic burden of chronic obstructive pulmonary disease by presence of comorbidities. Chest. 2015;147:1199–201.

    Article  PubMed  Google Scholar 

  6. Donner CF, Virchow JC, Lusuardi M. Pharmacoeconomics in COPD and inappropriateness of diagnostics, management and treatment. Respir Med. 2011;105:828–37.

    Article  PubMed  Google Scholar 

  7. Sullivan SD, Ramsey SD, Lee TA. The economic burden of COPD. Chest. 2000;117(Suppl. 2):5–9s.

    Article  Google Scholar 

  8. Sullivan SD, Buist AS, Weiss K. Health outcomes assessment and economic evaluation in COPD: challenges and opportunities. Eur Respir J Suppl. 2003;41:1–3s.

    Article  Google Scholar 

  9. Lee TA, Sullivan SD, Buist AS, Vollmer W, Weiss KB. Estimating the future burden of COPD; 2006; ATS Abstract Issue, vol. 3: A598.

    Google Scholar 

  10. National Heart, Lung, and Blood Institute. Morbidity and mortality: 2009 chart book on cardiovascular, lung, and blood diseases. http://www.nhlbi.nih.gov/resources/docs/2009_ChartBook.pdf. accessed 18.01.2010.

  11. Croxton TL, Bailey WC. Long-term oxygen treatment in chronic obstructive pulmonary disease: recommendations for future research: an NHLBI workshop report. Am J Respir Crit Care Med. 2006;174:373e8.

    Article  Google Scholar 

  12. Dal NR, Berto P, Tognella S, Quareni L. Cost-of-illness of lung disease in the TriVeneto Region, Italy: the GOLD study. Monaldi Arch Chest Dis. 2002;57:1–7.

    Google Scholar 

  13. Dal Negro RW, Tognella S, Tosatto R, Dionisi M, Turco P, Donner CF. Costs of chronic obstructive pulmonary disease (COPD) in Italy: the SIRIO study. Respir Med. 2008;102:92–101.

    Article  CAS  PubMed  Google Scholar 

  14. Dal Negro RW, Bonadiman L, Turco P, Tognella S, Iannazzo S. Costs of illness analysis in Italian patients with chronic obstructive pulmonary disease (COPD): an update. Clinicoecon Outcomes Res. 2015;7:153–9.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Sculpher M. Using economic evaluations to reduce the burden of asthma and chronic obstructive pulmonary disease. Pharmacoeconomics. 2001;19(Suppl. 2):21–5.

    Article  PubMed  Google Scholar 

  16. Ruchlin HS, Dasbach AJ. An economic overview of chronic obstructive pulmonary disease. Pharmacoeconomics. 2001;19:623–42.

    Article  CAS  PubMed  Google Scholar 

  17. Rennard S, Decramer M, Calverley PMA, et al. Impact of COPD in North America and Europe in 2000: subjects’ perspective of Confronting COPD International Survey. Eur Respir J. 2002;20:799–805.

    Article  CAS  PubMed  Google Scholar 

  18. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3(11):e442.

    Article  PubMed  PubMed Central  Google Scholar 

  19. van Boven JF, Vegter S, van der Molen T, Postma MJ. COPD in the working age population: the economic impact on both patients and government. COPD. 2013;10:629–39.

    Article  PubMed  Google Scholar 

  20. Grupo DAFNE- Direct costs to primary care of chronic bronchitis. Analysis of a prospective study. Aten Primaria. 2001;27:399–4.

    Google Scholar 

  21. Rutten van-Molken MP, Feenstra TL. The burden of asthma and chronic obstructive pulmonary disease: data from The Nederlands. Pharmacoeconomics. 2001;19 Suppl. 2:1–6.

    Article  PubMed  Google Scholar 

  22. Shaya FT, Dongyi D, Akazawa MO, Blanchette CM, Wang J, Mapel DW, Dalal A, Scharf SM. Burden of concomitant asthma and COPD in a Medical population. Chest. 2008;134:14–9.

    Article  PubMed  Google Scholar 

  23. Srivastava K, Thakur D, Sharma S, Punekar YS. Systematic review of humanistic and economic burden of symptomatic chronic obstructive pulmonary disease. Pharmacoeconomics. 2015;33:467–88.

    Article  PubMed  Google Scholar 

  24. Shaya FT, Maneval MS, Gbarayor CM, Sohn K, Dalal A, Du D, Scharf SM. Burden of COPD, asthma, and concomitant COPD and asthma among adults: racial disparities in a medical population. Chest. 2009;136:405–11.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Shaya FT, Lin PJ, Aljiawadi MH, Scharf SM. Elevated economic burden in obstructive lung disease patients with concomitant sleep apnea syndrome. Sleep Breath. 2009;13:317–23.

    Article  PubMed  Google Scholar 

  26. Patel JG, Nagar SP, Dala AA. Indirect costs in chronic obstructive pulmonary disease: e reiew of the economic burden on employers and individuals in the United states. Int J Chron Obstruct Pulmon Dis. 2014;19:289–300.

    Article  Google Scholar 

  27. Hilleman DE, Dewan N, Malesker M, Friedman M. Pharmacoeconomic evalutation of COPD. Chest. 2000;118:1278–85.

    Article  CAS  PubMed  Google Scholar 

  28. Toy EL, Gallagher KF, Stanley EL, Swensen AR, Duh MS. The economic impact of exacerbations of chronic obstructive pulmonary disease and exacerbation definition: a review. COPD. 2010;7:214–28.

    Article  PubMed  Google Scholar 

  29. Jahnz-Rozyk K, Targowski T, From S. Costs of exacerbations of chronic obstructive pulmonary disease in primary ans secondary care in 2007—results of a multicenter Polish study. Pol Menkur Lekarski. 2009;26:208–14.

    Google Scholar 

  30. Seemungal TA, Donaldson GC, Bhowmik A, Jeffries DJ, Wedzicha JA. Time course and recovery of exacerbations in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2000;161(5):1608–13.

    Article  CAS  PubMed  Google Scholar 

  31. Soler-Cataluña JJ, Martínez-García MA, Román Sánchez P, Salcedo E, Navarro M, Ochando R. Severe acute exacerbations and mortality in patients with chronic obstructive pulmonary disease. Thorax. 2005;60(11):925–31.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Simoens S, Decramer M. Pharmacoeconomics of the management of acute exacerbations of chronic obstructive pulmonary disease. Expert Opin Pharmacother. 2007;8:633–48.

    Article  CAS  PubMed  Google Scholar 

  33. Mapel DW, Schum M, Lydick E, MArton JP. A new method for examining the cost savings of reducing COPD exacerbations. Pharmacoeconomics. 2010;28:733–49.

    Article  PubMed  Google Scholar 

  34. Dal Negro RW, Celli BR. The BODECOST Index (BCI): a composite index for assessing the impact of COPD in real life. Multidiscip Respir Med. 2016;11:10.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Tantucci C, Modina D. Lung function decline in COPD. Int J ChronObstruct Pulmon Dis. 2012;7:95–9.

    Article  Google Scholar 

  36. Ramsey SD, Sullivan SD. Chronic obstructive pulmonary disease: is there a case for early intervention? Am J Med. 2004;117 Suppl 12A:3S–10S.

    PubMed  Google Scholar 

  37. Zoia MC, Corsico AG, Beccaria M, Guarnone R, Cervio G, Testi R, Bressan MA, Pozzi E, Cerveri I. Exacerbations as a starting point of pro-active chronic obstructive pulmonary disease management. Respir Med. 2005;99(12):1568–75.

    Article  PubMed  Google Scholar 

  38. Menn P, Leidl R, Holle R. A lifetime Markov model for the economic evaluation of chronic obstructive pulmonary disease. Pharmacoeconomics. 2012;30(9):825–40.

    Article  PubMed  Google Scholar 

  39. Getsios D, Marton JP, Revankar N, Ward AJ, Willke RJ, Rublee D, Ishak KJ, Xenakis JG. Smoking cessation treatment and outcomes patterns simulation: a new framework for evaluating the potential health and economic impact of smoking cessation interventions. Pharmacoeconomics. 2013;31(9):767–80.

    Article  PubMed  Google Scholar 

  40. Jiménez-Ruiz CA, Solano-Reina S, Signes-Costa J, de Higes-Martinez E, Granda-Orive JI, Lorza-Blasco JJ, Riesco-Miranda JA, Altet-Gomez N, Barrueco M, Oyagüez I, Rejas J, SESEPARAR’s Integrated Tobacco Research Program. Budgetary impact analysis on funding smoking-cessation drugs in patients with COPD in Spain. Int J Chron Obstruct Pulmon Dis. 2015;10:2027–36.

    PubMed  PubMed Central  Google Scholar 

  41. Howard P, Knight C, Boler A, Baker C. Cost-utility analysis of varenicline versus existing smoking cessation strategies using the BENESCO Simulation model: application to a population of US adult smokers. Pharmacoeconomics. 2008;26(6):497–511.

    Article  CAS  PubMed  Google Scholar 

  42. Lee KH, Phua J, Lim TK. Evaluating the pharmacoeconomic effect of adding tiotropium bromide to the management of chronic obstructive pulmonary disease patients in Singapore. Respir Med. 2006;100(12):2190–6.

    Article  PubMed  Google Scholar 

  43. Zaniolo O, Iannazzo S, Pradelli L, Miravitlles M. Pharmacoeconomic evaluation of tiotropium bromide in the long-term treatment of chronic obstructive pulmonary disease (COPD) in Italy. Eur J Health Econ. 2012;13(1):71–80.

    Article  CAS  PubMed  Google Scholar 

  44. Ferroni E, Belleudi V, Cascini S, Di Martino M, Kirchmayer U, Pistelli R, Patorno E, Formoso G, Fusco D, Perucci CA, Davoli M, Agabiti N, OUTPUL study group. Role of tiotropium in reducing exacerbations of chronic obstructive pulmonary disease when combined with long-acting Β2-agonists and inhaled corticosteroids: the OUTPUL Study. J Clin Pharmacol. 2016; doi:10.1002/jcph.750. [Epub ahead of print]

  45. Halpin DM. Symbicort: a pharmacoeconomic review. J Med Econ. 2008;11:345–62.

    Article  PubMed  Google Scholar 

  46. Najafzadeh M, Marra CA, Sadatsafavi M, Aaron SD, Sullivan SD, Vandemheen KL, Jones PW, Fitzgerald JM. Cost effectiveness of therapy with combinations of long acting bronchodilators and inhaled steroids for treatment of COPD. Thorax. 2008;63(11):962–7.

    Article  CAS  PubMed  Google Scholar 

  47. Dal Negro R, Bonadiman L, Tognella S, Micheletto C, Turco P. The impact of LABA+ICS fixed combinations on morbidity and economic burden of COPD in Italy: a six-year observational study. Ther Adv Respir Dis. 2011;5(2):83–90.

    Article  PubMed  Google Scholar 

  48. Simoens S, Decramer M. A pharmacoeconomic review of the management of respiratory tract infections with moxafloxacin. Expert Opin Pharmacother. 2008;9:1735–44.

    Article  CAS  PubMed  Google Scholar 

  49. Simoens S, Laekeman G, Decramer M. Preventing COPD exacerbations with macrolids; a review and budget impact analysis. Respir Med. 2013;107:637–48.

    Article  PubMed  Google Scholar 

  50. Simoens S, Decramer M, Laekeman G. Economic aspects of antimicrobial therapy of acute exacerbations of COPD. Respir Med. 2007;101(1):15–26.

    Article  PubMed  Google Scholar 

  51. Rutten-van Mölken MP, van Nooten FE, Lindemann M, Caeser M, Calverley PM. A 1-year prospective cost-effectiveness analysis of roflumilast for the treatment of patients with severe chronic obstructive pulmonary disease. Pharmacoeconomics. 2007;25(8):695–711.

    Article  PubMed  Google Scholar 

  52. Moretti M, Bottrighi P, Dallari R, Da Porto R, Dolcetti A, Grandi P, Garuti G, Guffanti E, Roversi P, De Gugliemo M, Potena A, EQUALIFE Study Group. The effect of long-term treatment with erdosteine on chronic obstructive pulmonary disease: the EQUALIFE Study. Drugs Exp Clin Res. 2004;30(4):143–52.

    PubMed  CAS  Google Scholar 

  53. Sclar DA, Evans MA, Robison LM, Skaer TL. α1-Proteinase inhibitor (human) in the treatment of hereditary emphysema secondary to α1-antitrypsin deficiency: number and costs of years of life gained. Clin Drug Investig. 2012;32(5):353–60.

    Article  CAS  PubMed  Google Scholar 

  54. Słominski JM, Kubiak A. Pharmacoeconomics of vaccinations in chronic obstructive pulmonary disease. Pol Merkur Lekarski. 2004;16(Suppl 1):83–5.

    PubMed  Google Scholar 

  55. Rodríguez González-Moro JM, Menéndez R, Campins M, Lwoff N, Oyagüez I, Echave M, Rejas J, Antoñanzas F. Cost effectiveness of the 13-valent pneumococcal conjugate vaccination program in chronic obstructive pulmonary disease patients aged 50+ years in Spain. Clin Drug Investig. 2016;36(1):41–53.

    Article  CAS  PubMed  Google Scholar 

  56. Dal Negro RW. The tele-control at home. In: Dal Negro RW, Hodder R, editors. Long-term oxygen therapy. New insights & perspectives. Milan: Springer Verlag; 2012. p. 171–84.

    Chapter  Google Scholar 

  57. Restrepo RD, Alvarez MT, Wittnebel LD, Sorenson H, Wettstein R, Vines DL, Sikkema-Ortiz J, Gardner DD, Wilkins RL. Medication adherence issues in patients treated for COPD. Int J Chron Obstruct Pulmon Dis. 2008;3(3):371–84.

    Article  PubMed  PubMed Central  Google Scholar 

  58. van Boven JF, Chavannes NH, van der Molen T, Rutten-van Mölken MP, Postma MJ, Vegter S. Clinical and economic impact of non-adherence in COPD: a systematic review. Respir Med. 2014;108(1):103–13.

    Article  PubMed  Google Scholar 

  59. Virchow JC, Crompton GK, Dal Negro RW, Pedersen S, Magnan A, Seidemberg J, et al. Importance of inhaler devices in the management of airway diseases. Respir Med. 2008;102:10–9.

    Article  CAS  PubMed  Google Scholar 

  60. van Boven JF, Tommelein E, Boussery K, Mehuys E, Vegter S, Brusselle GG, Rutten-van Mölken MP, Postma MJ. Improving inhaler adherence in patients with chronic obstructive pulmonary disease: a cost-effectiveness analysis. Respir Res. 2014;15:66. doi:10.1186/1465-9921-15-66.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Dal Negro RW, Povero M. The economic impact of educational training assessed by the Handling Questionnaire with three inhalation devices in asthma and Chronic Obstructive Pulmonary Disease patients. Clinicoeconomics Outcomes Res. 2016;8:171–6.

    Google Scholar 

  62. Spruit MA, Singh SJ, Garvey C, Zuwallack R, Nici L, Rochester C, Hill K, Holland AE, Lareau SC, Man WD, Pitta F, Sewell L, Raskin J, Bourbeau J, Crouch R, Franssen FM, Casaburi R, Vercoulen JH, Vogiatzis I, Gosselink R, Clini EM, Effing TW, Maltais F, van der Palen J, Troosters T, Janssen DJ, Collins E, Garcia-Aymerich J, Brooks D, Fahy BF, Puhan MA, Hoogendoorn M, Garrod R, Schols AM, Carlin B, Benzo R, Meek P, Morgan M, Rutten-van Mölken MP, Ries AL, Make B, Goldstein RS, Dowson CA, Brozek JL, Donner CF, Wouters EF, ATS/ERS Task Force on Pulmonary Rehabilitation. An official American Thoracic Society/European Respiratory Society statement: Key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013;188(8):e13–64. doi:10.1164/rccm.201309-1634ST.

    Article  PubMed  Google Scholar 

  63. Rochester CL, Vogiatzis I, Holland AE, Lareau SC, Marciniuk DD, Puhan MA, Spruit MA, Masefield S, Casaburi R, Clini EM, Crouch R, Garcia-Aymerich J, Garvey C, Goldstein RS, Hill K, Morgan M, Nici L, Pitta F, Ries AL, Singh SJ, Troosters T, Wijkstra PJ, Yawn BP, RL ZW. ATS/ERS Task Force on Policy in Pulmonary Rehabilitation. Am J Respir Crit Care Med. 2015;192(11):1373–86.

    Article  PubMed  Google Scholar 

  64. Goldstein RS, Gort EH, Guyatt GH, Feeny D. Economic analysis of respiratory rehabilitation. Chest. 1997;112:370–9.

    Article  CAS  PubMed  Google Scholar 

  65. Jain VV, Allison R, Beck SJ, Jain R, Mills PK, McCurley JW, Van Gundy KP, Peterson MW. Impact of an integrated disease management program in reducing exacerbations in patients with severe asthma and COPD. Respir Med. 2014;108(12):1794–800.

    Article  PubMed  Google Scholar 

  66. Burns DK, Wilson EC, Browne P, Olive S, Clark A, Galey P, Dix E, Woodhouse H, Robinson S, Wilson A. The cost effectiveness of maintenance schedules following pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: an economic evaluation alongside a randomised controlled trial. Appl Health Econ Health Policy. 2016;14(1):105–15.

    Article  PubMed  Google Scholar 

  67. Dritsaki M, Johnson-Warrington V, Mitchell K, Singh S, Rees K. An economic evaluation of a self-management programme of activity, coping and education for patients with chronic obstructive pulmonary disease. Chron Respir Dis. 2016;13(1):48–56.

    Article  PubMed  Google Scholar 

  68. Howard-Wilsher S, Irvine L, Fan H, Shakespeare T, Suhrcke M, Horton S, Poland F, Hooper L, Song F. Systematic overview of economic evaluations of health-related rehabilitation. Disabil Health J. 2016;9(1):11–25.

    Article  PubMed  Google Scholar 

  69. Prescott E, Lange P, Vestbo J. Socioeconomic status, lung function and admission to hospital for COPD: results from the Copenhagen City Health Study. Eur Respir J. 1999;13:1109–14.

    Article  CAS  PubMed  Google Scholar 

  70. Thorn J, Bjorkelund C, Bengtsson C, Guo X, Lissenr L, Sundh V. Low socio-economic status, smoking, mental stress and obesity predict obstructive symptoms in women, but only smoking also predicts subsequent experience of poor health. Int J Med Sci. 2006;4:7–12.

    PubMed  PubMed Central  Google Scholar 

  71. Kanervist M, Vasankari T, Laitinen T, Heliovaara M, Jpusilathi P, Saarelainen S. Low socioeconomic status is associated with chronic obstructive airway disease. Respir Med. 2011;105:1140–6.

    Article  Google Scholar 

  72. Bousquet J, Dahl R, Khaltaev N. Global Alliance against chronic respiratory disease. Allergy. 2007;62:216–23.

    Article  CAS  PubMed  Google Scholar 

  73. Roberts MH, Borrego ME, Kharat AA, Marshik PL, Mapel DW. Economic evaluations of fluticasone-propionate/salmeterol combination therapy for chronic obstructive pulmonary disease: a review of published studies. Expert Rev Pharmacoecon Outcomes Res. 2016;16(2):167–92.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. National Centre for Respiratory Pharmacoeconomics and Pharmacoepidemiology, CESFAR, Verona, Italy

    Roberto W. Dal Negro

  2. Mondo Medico, Multidisciplinary and Rehabilitation Outpatient Clinic, Borgomanero, Novara, Italy

    Claudio F. Donner

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  1. Roberto W. Dal Negro
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  2. Claudio F. Donner
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Correspondence to Claudio F. Donner .

Editor information

Editors and Affiliations

  1. Department of Medical and Surgical Sciences, University of Modena, Azienda Ospedaliero Universitaria di Modena Policlinico, Modena, Italy

    Enrico Clini

  2. Alfred Health and Institute for Breathing and Sleep, La Trobe University, Melbourne, Australia

    Anne E. Holland

  3. State University of Londrina, Londrina, Paraná, Brazil

    Fabio Pitta

  4. Department of Rehabilitation Sciences, KU Leuven, Respiratory Division and Rehabilitation, University Hospital Leuven, Leuven, Belgium

    Thierry Troosters

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Dal Negro, R.W., Donner, C.F. (2018). COPD: Economical and Surrogate Outcomes—The Case of COPD. In: Clini, E., Holland, A., Pitta, F., Troosters, T. (eds) Textbook of Pulmonary Rehabilitation. Springer, Cham. https://doi.org/10.1007/978-3-319-65888-9_20

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