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      Cost trends among commercially insured and Medicare Advantage-insured patients with chronic obstructive pulmonary disease: 2006 through 2009

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          Abstract

          Background

          Few estimates of health care costs related to chronic obstructive pulmonary disease (COPD) are available regarding commercially insured patients in the United States. The aims of this retrospective observational analysis of administrative data were to describe and compare health care resource use and costs related to COPD in the United States for patients with commercial insurance or Medicare Advantage with Part D benefits, and to assess cost trends over time.

          Methods

          Patient-level and visit-level health care costs in the calendar years 2006, 2007, 2008, and 2009 were assessed for patients with evidence of COPD. Generalized linear models adjusting for sex, age category, and geographic region were used to investigate cost trends over time for patients with Medicare or commercial insurance.

          Results

          Medical costs, which ranged from an annual mean of US$2382 (Medicare 2007) to US$3339 (commercial 2009) per patient, comprised the majority of total costs in all years for patients with either type of insurance. COPD-related costs were less for Medicare than commercial cohorts. In the multivariate analysis, total costs increased by approximately 6% per year for commercial insurance patients (cost ratio 1.06; 95% confidence interval [CI] 1.04–1.07; P < 0.001) and 5% per year for Medicare patients (cost ratio 1.05; 95% CI 1.03–1.07; P < 0.001). Costs for outpatient and emergency department visits increased significantly over time in both populations. Standard admission costs increased significantly for Medicare patients (cost ratio 1.03; 95% CI 1.00–1.05; P = 0.03), but not commercial patients, and costs for intensive care unit visits remained stable for both populations.

          Conclusion

          COPD imposed a substantial economic burden on patients and the health care system, with costs increasing significantly in both the Medicare and commercial populations.

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          Most cited references 26

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          Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper.

           W MacNee,  ,  B Celli (2004)
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              The logged dependent variable, heteroscedasticity, and the retransformation problem.

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                Author and article information

                Journal
                Int J Chron Obstruct Pulmon Dis
                International Journal of COPD
                International Journal of Chronic Obstructive Pulmonary Disease
                Dove Medical Press
                1176-9106
                1178-2005
                2011
                2011
                14 October 2011
                : 6
                : 533-542
                Affiliations
                [1 ]US Health Outcomes, GlaxoSmithKline, Research Triangle Park, Durham, NC
                [2 ]Health Economics and Outcomes Research, OptumInsight, Eden Prairie, MN, USA
                Author notes
                Correspondence: Anand A Dalal, GlaxoSmithKline, 5 Moore Dr, Bide West, Mail Stop B-3153, Durham, NC 27709, USA, Tel +1 919 483 7286, Fax +1 919 483 7932, Email anand.a.dalal@ 123456gsk.com
                Article
                copd-6-533
                10.2147/COPD.S24591
                3206770
                22069365
                © 2011 Dalal et al, publisher and licensee Dove Medical Press Ltd.

                This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

                Categories
                Original Research

                Respiratory medicine

                economics, managed care, lung diseases

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