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Observational Study
. 2018 Jul 30:13:2301-2311.
doi: 10.2147/COPD.S163795. eCollection 2018.

COPD affects worker productivity and health care costs

Jeetvan G Patel  1 , Anna D Coutinho  2 , Orsolya E Lunacsek  2 , Anand A Dalal  3
Affiliations
Observational Study

COPD affects worker productivity and health care costs

Jeetvan G Patel et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Purpose: This study aimed to measure the true burden of COPD by calculating incremental direct and indirect costs. Direct medical resource use, productivity metrics, and COPD-specific resource use and costs were also evaluated.

Patients and methods: This was a retrospective, observational, matched cohort study using administrative claims data from the Truven Health MarketScan® Commercial Claims and Encounters and the Health and Productivity Management databases (2007-2010). Working-age (18-65 years) patients with COPD were identified as having at least one hospitalization or one emergency department visit or two outpatient visits. Patients in the non-COPD cohort did not have a diagnosis of COPD during the study period. Outcomes were evaluated in the first full calendar year after the year of identification (index).

Results: Of the 5,701 patients with COPD identified, 3.6% patients were frequent exacerbators (≥2), 10.4% patients were infrequent exacerbators (1), and 86% patients were non-exacerbators (0). When compared with the 17,103 patients without COPD, the incremental direct cost of COPD was estimated at $6,246/patient/year (95% confidence interval: $4,620, $8,623; P<0.001). Loss in productivity was significantly greater in patients with COPD, with an average of 5 more days/year of absence from work and incremental indirect costs from short-term disability of $641 (P<0.001). Direct costs for frequent exacerbators ($17,651/year) and infrequent exacerbators ($14,501/year) were significantly higher than those for non-exacerbators ($11,395, P<0.001).

Conclusion: Working-age patients with COPD incur statistically significantly higher direct and indirect costs and use more resources compared with those who do not have COPD.

Keywords: COPD; cost; employer; exacerbation; productivity; resource.

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Conflict of interest statement

Disclosure JGP and AAD were employees of GSK at the time of the study conduct. JGP is currently an employee of Amgen and owns stocks/shares. AAD is currently an employee of Novartis Pharmaceuticals and owns stocks/shares. ADC and OEL are employees of Xcenda, a health care consulting company contracted by GSK for the conduct of this study. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Annual adjusteda direct and indirect costs between COPD and non-COPD cohorts. Notes: Sample evaluated – direct costs: COPD (n=5,701) and non-COPD (n=17,103) and short-term disability: COPD (n=5,514) and non-COPD (n=16,542). aAdjusted for comorbidities included in the CCI, including those associated with COPD. *P<0.001. Abbreviations: CCI, Charlson Comorbidity Index; USD, US dollar.
Figure 2
Figure 2
Annual adjusteda productivity metrics by exacerbator status. Notes: aAdjusted for comorbidities included in the CCI, including those associated with COPD. bP-value – compared with non-exacerbators. Abbreviation: CCI, Charlson Comorbidity Index.
Figure 3
Figure 3
Adjusted indirect costs per year by exacerbator status. Note: aP-value – compared with non-exacerbators. Abbreviation: USD, US dollar.
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