Healthcare costs of COPD in Italian referral centres: A prospective study

SummaryBackgroundThis study estimated the healthcare resource utilisation and costs of chronic obstructive pulmonary disease (COPD) patients, staged by severity, in the Italian pneumology departments (PDs).MethodsThe project was a multi-centre observational study conducted in 11 Italian PDs throughout the country.A total of 268 patients were recruited and followed prospectively for 1 year. For the purpose of analysis, patients were divided into four groups according to the severity at onset:
• mild COPD (stage I)—postbronchodilator FEV1/FVC <70% and FEV1 ⩾ 80% of predicted;
• moderate COPD (stage II)—postbronchodilator FEV1/FVC <70% and 50% ⩽FEV1< 80% of predicted;
• severe COPD (stage III)—postbronchodilator FEV1/FVC <70% and 30% ⩽FEV1 <50% of predicted;
• very severe COPD (stage IV)—postbronchodilator FEV1/FVC <70% and FEV1 <30% of predicted, or clinical signs of either respiratory or cardiac failure.ResultsSubgroups differed significantly in the main demographic and clinical variables. Broadly, higher severity was associated with older age, longer disease duration, and more frequent exacerbations. Patients with severe COPD used more resources for almost all services than those with mild and moderate forms.The annual average cost per patient was €3040.2 (€1046.7 for mild, €2319.0 for moderate, €3572.1 for severe and €5033.3 for very severe forms).ConclusionsThis study offers some information on the healthcare costs of COPD induced by PDs in Italy, potentially useful for decision-making in the health care services. Resources and costs rose significantly with disease severity.