gms | German Medical Science

Objectives: Data on treatment and costs of COPD for Germany are sparse. This study aims at investigating into the resource utilization of COPD patients by analysing the cost related to outpatient drug prescriptions, remedies and medical devices as well as hospitalizations.

Methods: Claims data from a German sickness fund for the year 2003 were used. Beneficiaries 45 years of age or older were identified as COPD patients by a combination of diagnostic and drug prescription data. Patients were allocated to COPD stages as defined by the GOLD guideline. Cost data were extracted from claims files. Hospitalization costs were estimated based on average costs per-day.

Results: n=38,469 beneficiaries were identified as COPD patients. Average costs amounted to 623 Euro per patient in 2003 (64% prescription drugs, 22% hospital care, 8% remedies, 6% medical devices). 65% of patients were at risk or had a mild disease (GOLD 0/1), 12% had a moderate disease (GOLD 2), and 22% had a severe disease (GOLD 3). GOLD 0/1 patients cause average costs of 208 Euro, GOLD 2 and GOLD 3 patients cause costs of 928 Euro and 1,823 Euro, respectively. While the share of prescription drug costs accounted for 37% of costs in GOLD 0/1 patients, the corresponding figures for GOLD 2 and GOLD 3 patients were 65% and 73%.

Conclusion: Costs observed are within a plausible range. They reveal that higher costs in more severe stages of COPD are mainly due to drug prescriptions. The study can not ascertain whether this result goes along with adequate or inadequate treatment. Moreover, uncertainties in assignment to stages could be responsible for the high proportion of drug costs in more severe stages. Nevertheless, the analysis shows that drug therapy is of major importance in health care delivery for COPD patients – also in terms of health economics.