Buist, S

Lee, T

Sullivan, S

Vollmer, W

Weiss, K

Elsevier - Publisher Connector 

PRS12 THE BURDEN OF LUNG DISEASE (BOLD) ECONOMIC MODEL 

A214 Abstracts
RESULTS: The strategy based on initial treatment with ﬂutica-
zone propionate nasal drops resulted with treatment cost of PLN
768, while early polypectomy resulted with cost of PLN 1251.
When surgery was performed in outpatients’ settings the mean
treatment costs were PLN 586 for initial ﬂuticazone and PLN
751 for early polypectomy. Sensitivity analysis revealed that
FPND is less costly therapy unless no computed tomography is
performed prior to polypectomy and the cost of surgical proce-
dure falls below PLN 170. CONCLUSIONS: Treatment strategy
based on ﬂuticasone propionate nasal drops is effective in bilat-
eral nasal polyposis and results in short-term cost savings.
PRS9
COST OF COMMUNITY ACQUIRED PNEUMONIA (CAP)
TREATMENT WITH KETEK (TELITHROMYCIN) VS
CLARITHROMYCIN FROM PUBLIC PAYER PERSPECTIVE 
IN POLAND
Kawalec P1, Lis J2, Gierczynski J2
1Jagiellonian University, Krakow, Poland; 2Sanoﬁ-Aventis Poland,
Warsaw, Poland
OBJECTIVES: To assess the clinical effectiveness and economic
consequences of telithromycin or clarithromycin in CAP treat-
ment from public payer perspective in Poland. METHODS:
Results of a systematic review of published clinical trials selected
in accordance with EBM criteria were used to assess effective-
ness and safety of the antibiotics in CAP treatment. The eco-
nomic consequences for public payer for therapy of individual
patient in case of clarithromycin replacement by Ketek
(telithromycin) were calculated. In this analysis it was assumed
that only pharmacotherapy costs and CAP hospitalization costs
differed; other costs were assumed to be the same irrelevant to
the antibiotic used. An assumption was made that level of phar-
macotherapy reimbursement in case of treatment with both
telithromycin and clarithromycin would be the same, public
payer costs for DDD were calculated. Costs of CAP hospitaliza-
tion varied on number of admissions during 1 month of follow-
up period. RESULTS: Clinical effects of the two drugs were
similar and no signiﬁcant differences in effectiveness or safety
were found in pooled data from two randomized clinical trials.
Telithromycin treatment was associated with signiﬁcantly fewer
CAP-related hospitalizations compared with clarithromycin
(1.6% vs 3.6% patients admitted, respectively). CAP-related
hospital costs per patient were much lower for telithromycin
treatment compared with clarithromycin (35.5pln (8.45E) vs.
79.2pln (18.8E) respectively). Taking into account reimburse-
ment of pharmacotherapy and costs of hospitalization, public
payer savings when using telithromycin in place of claritromycin
could be as high as 33pln(7.8E) - 50pln(12E)/patient (based on
sensitivity analysis). This lead to high annual savings for public
payer. CONCLUSIONS: Ketek (telithromycin) in place of clar-
ithromycin lead to signiﬁcant savings for public payer in CAP
treatment in Poland.
PRS10
PROJECTING THE FUTURE COSTS OF ASTHMA AND COPD
IN THE NETHERLANDS
Hoogendoorn M1, Rutten-van Molken MP1, Feenstra TL2
1Erasmus MC, Rotterdam,The Netherlands; 2National Institute for
Public Health and the Environment (RIVM), Bilthoven,The
Netherlands
OBJECTIVE: This study aimed to project future costs of asthma
and chronic obstructive pulmonary disease (COPD) in The
Netherlands for the period 2000–2025. METHODS: Gender-,
age- and (for COPD) disease-stage speciﬁc data on direct,
medical costs per patient were obtained from a cost of illness
study for the year 2000. Cost projections over the period
2000–2025 were based on two types of projections of the preva-
lence of asthma and COPD. Both prevalence projections were
combined with two types of cost projections; ﬁrst assuming con-
stant costs per patient and second adding asthma and COPD-
speciﬁc trends in costs for hospital care (asthma, -4.7% and
COPD, -4.1% per year) and medication (+4.9% per year) and
general trends in remaining cost categories. RESULTS: In 2000
the annual costs per asthma patient were €315, compared to
€915 for a COPD patient. Assuming constant costs per patient,
costs were projected to increase from €141 million in 2000 to
amounts between 167 and €181 million for asthma and from
280 to €443–495 million for COPD. Severity stage speciﬁc
COPD costs increased from 22.6 to 51.2 for mild COPD, from
104 to 148 for moderate, from 99.0 to 140 for severe and from
54.5 to €156 million for very severe COPD. Including trends
costs categories resulted in estimates between 460 and 497 for
asthma and 1023 and €1130 million for COPD. CONCLU-
SION: Projections of future costs show that the absolute and rel-
ative increase in costs over the period 2000–2025 is higher for
COPD than for asthma.
PRS11
MANAGEMENT OF COPD IN BELGIUM: A REAL LIFE COST OF
ILLNESS STUDY
Caekelbergh K, Spaepen E,Annemans L
IMS Health, Brussels, Belgium
OBJECTIVES: To assess the cost of managing COPD (health
care payers perspective) in a real life setting in Belgium.
METHODS: A multi-centre observational study with data-
collection in a retrospective way (one-year) was performed. A
total of 38GPs and 15pneumologists participated. Patients con-
sulting the physicians in Q4 2004–Q1 2005 were eligible. Indi-
vidual data-collection sheets per patient, evaluating the yearly
medical resource use, were completed by each investigator. Diag-
nostic methods, COPD severity, as well as smoking habits were
evaluated. RESULTS: A total of 460 patients were evaluated.
Mean age was 66 years, males represented 68.70%. 40.43% of
patients were smokers (average n pack-years 36.69, StErr 1.54),
50.22% ex-smokers. COPD diagnosis was made in about half
of the patients by both clinical evaluation and spirometry. A total
of 13% of the patients had mild COPD, 47% moderate, 30%
severe and 10% very severe COPD according to clinical evalua-
tion or spirometry (GOLD-guidelines). A total of 73% of the
patients experienced at least 1 exacerbation during the 1-year-
study-period. Yearly number of exacerbations ranged between 0
and 12 (average n: 1.37, median: 1.00). In most cases (69.64%),
no hospitalisation was needed. If hospitalized, average hospital
stay per exacerbation was 13.30 days (StErr 1.03). Yearly
COPD-maintenance-treatment cost ranged between 390€ (mild)
to €1117 (very severe COPD). Maintenance-treatment included
a wide range of medications. Management of COPD resulted in
a total yearly cost of €1810 (StErr 139.55, range €537 (mild
COPD)—€5888 (very severe COPD)), including maintenance-
treatment (€670, StErr 26.67), hospitalisation (€1073, StErr
130.16) and treatment of exacerbations (€67, StErr 6.78). CON-
CLUSIONS: Management of COPD is costly, mainly due to the
cost of hospitalisations. For very severe COPD patients, yearly
management costs increase up to almost €6000.
PRS12
THE BURDEN OF LUNG DISEASE (BOLD) ECONOMIC MODEL
Sullivan S1, Lee T2,Weiss K2, Buist S3,Vollmer W4
1University of Washington, Seattle, WA, USA; 2Northwestern
University, Chicago, IL, USA; 3Oregon Health and Sciences Center,
Portland, OR, USA; 4Kaiser Permanente, Portland, OR, USA
A215Abstracts
OBJECTIVES: Chronic disease imparts signiﬁcant disability, pre-
mature mortality and economic burden on countries. Chronic
obstructive pulmonary disease (COPD) will be the ﬁfth leading
cause of disability-adjusted mortality in 2020. Causative expo-
sures include tobacco smoke, biomass fuels, occupational and
other environmental factors. The Burden of Obstructive Lung
Disease (BOLD) project will estimate the prevalence and burden
of COPD globally. Here, we on the design, development and
application of a population simulation model to forecast
country-speciﬁc economic burden of COPD. To show feasibility
of the model, we report US burden data. METHODS: A pub-
licly available population simulation model was developed to
estimate annual and future mortality and costs. The model
reﬂects changes in the size, composition and population demo-
graphics of the jurisdiction. Input data include disease prevalence
from the BOLD COPD epidemiology studies, tobacco smoking
and cessation rates, background mortality, disease attributable
mortality, annual incidence of COPD, lung function progression
data from the Framingham Heart Study and costs. Simulations
are based on a starting cohort age 20 years and older in 2005.
Five, 10 and 20-year projections are discounted at 3% per year.
RESULTS: The model projects COPD prevalence to increase
each year. In 2005, the projected cost of COPD in the US was
$51.4 billion in medical expenses or $256 per capita. Cumula-
tive discounted 5, 10 and 20 year medical costs for COPD were
$304.9 billion, $678.4 billion and $1415.3 billion. CONCLU-
SIONS: COPD is one of the world’s leading causes of disability
and mortality. The economic consequences of tobacco use and
occupational exposures leading to COPD are substantial. We
developed this model as part of a global burden identiﬁcation
and reduction project. Here, we show its application for burden
simulation with US data, but intend a larger global effort in con-
junction with the BOLD project.
PRS13
COST ANALYSIS OF HEALTH CARE RESOURCE UTILIZATION
DURING TREATMENT FOR RESPIRATORY TRACK INFECTIONS
(RTIS) WITH TELITHROMYCIN OR CLARITHROMYCIN OR
AMOXICILLIN/CLAVULANIC ACID IN GREECE
Angeli A1, Maniadakis N2
1Sanoﬁ Aventis Greece, Athens, Athens, Greece; 2University Hospital
of Heraklion, Crete, Greece
OBJECTIVES: To compare direct medical costs related to 
the management of community acquired pneumonia (CAP) 
and acute exacerbations of chronic bronchitis (AECB) 
between telithromycin (TEL) and clarithromycin (CLA) or
amoxicillin/clavulanic acid (AMC), in both public and private
sector in Greece. METHODS: A health outcomes model was
developed from three Phase III multinational clinical studies
comparing TEL with CLA in CAP, and with AMC in AECB. In
each study patients were followed for 36 days and the primary
endpoint was clinical efﬁcacy at post therapy visit. Health care
resources included in the model were additional non-protocol
antibiotics, hospitalizations, laboratory tests and outpatient
health care professional visits. Two cost analyses were per-
formed; one from the perspective of Greek Health care System
by using public sector unit costs and one from private sector per-
spective in Greece (including both reimbursable costs and out of
pocket costs) in an effort to present a more realistic case for
Greece. RESULTS: From the Greek Health care System perspec-
tive, the use of TEL instead of CLA in CAP resulted in cost
savings of up to €49 per patient and up to €20 per patient when
compared with AMC in AECB. For the Greek private sector, TEL
cost differences were even greater, up to €71 when administered
for CAP instead of CLA and up to €28 in AECB instead of AMC.
The cost savings resulted from TEL patients required fewer non-
protocol additional health care resources (mainly a lower rate of
hospitalization and shorter length of stay) than the patients in
the comparator groups in both CAP and AECB. CONCLU-
SION: In Greece the use of telithromycin as a ﬁrst line treatment
option for CAP and AECB instead of clarithromycin or amoxi-
cillin/clavulanic acid respectively, may signiﬁcantly reduce health
care costs in both public and private sector.
PRS14
HEALTH CARE RESOURCES UTILIZATION IN PATIENTS WITH
CHRONIC OBSTRUCTIVE PULMONARY DISEASE ACCORDING
TO THEIR SEVERITY IN SPAIN
De Lucas P1, Rodríguez JM1, Martin A2, Soto J2
1Gregorio Marañon Hospital, Madrid, Spain; 2Pﬁzer Spain, Alcobendas,
Madrid, Spain
OBJECTIVE: Chronic obstructive pulmonary disease (COPD)
accounts for about 10% of patient visits to a pneumologist, 7%
of all hospital admissions, and 35% of permanent work disabil-
ity. The aim of this study has been to assess health care resources
utilization in Spain depending on the severity of the disease.
METHODS: This analysis has been carried out through the
design of a one-year retrospective naturalistic study performed
through the whole Spanish territory, including both urban and
rural areas. There have been included 9,045 COPD patients with
a mean age of 67 ± 9.8 years. The severity of the disease was as
follows: 33.8% mild (FEV1: 60–80% of predicted), 49.3% mod-
erate (FEV1: 40–60% of predicted) and 16.8% severe (FEV1 <
40% of predicted). Health care resources collected were: added
visits to the general practitioner (GP) and pneumologist, added
visits to the emergency room, length of stay in the hospital and
number of days off work. RESULTS: Severe COPD patients pre-
sented more added visits to the GP compared to moderate and
mild COPD patients (5.83, 4.65 and 3.25 respectively, p <
0.001), likewise with regard to added visits to the pneumologist
(1.55, 1.09 and 0.62 respectively, p < 0.001) and added visits to
the emergency room (2.50, 1.62 and 0.9 respectively, p < 0.001).
In addition, severe COPD patients showed a longer length of stay
in the hospital than moderate and mild COPD patients (16.7 vs.
10.9 and 8.8 days respectively, p < 0.001) and less days off work
(51.2, 29.4 and 18.9 respectively, p < 0.01). CONCLUSIONS:
Severe COPD patients require higher health care resources uti-
lization than moderate and mild patients. Therefore, it is neces-
sary to elaborate programs and policies focused in diagnosing
early COPD patients to try to avoid progression of mild patients
to moderate and severe stages of the disease.
PRS15
OUTCOMES, RESOURCE CONSUMPTION AND COSTS OF
INTENSIVE CARE PATIENTS HOSPITALIZED WITH ACUTE
RESPIRATORY DISTRESS SYNDROME (ARDS) IN THE USA
AND CANADA
Eichmann F1, Reitberger U1, Caeser M2
1Kendle GmbH & Co GMI KG, München, Germany; 2Altana Pharma
AG, Konstanz, Germany
OBJECTIVES: To describe ARDS patients regarding survival,
ventilation status, predisposing events, disease characteristics,
length of hospital stay and duration of ventilation. METHODS:
In a phase III clinical trial investigating treatment with Venticute
(rSPC surfactant) compared to standard treatment in patients
hospitalized for ARDS (NEJM 351, 884–892, 2004), patients
were followed up for up to one year after randomization. This
analysis is focused on the initial hospitalization and describes the
pooled results from both treatment groups. Data were collected
for 197 patients by means of a speciﬁc questionnaire covering


file:///data/core-remote/dit/data/elsevier/pdf/190/aHR0cDovL2FwaS5lbHNldmllci5jb20vY29udGVudC9hcnRpY2xlL3BpaS9zMTA5ODMwMTUxMDY3ODA4NA==.pdf

PRS12 THE BURDEN OF LUNG DISEASE (BOLD) ECONOMIC MODEL

Abstract

Similar works

Full text

Available Versions

Elsevier - Publisher Connector

Elsevier - Publisher Connector