The Burden Of Chronic Obstructive Pulmonary Disease (COPD) In Finland: Impact Of Disease Severity And Eosinophil Count On Healthcare Resource Utilization

Purpose: The burden associated with chronic obstructive pulmonary disease (COPD) is substantial. The objectives of this study were to describe healthcare resource utilization (HCRU) and HCRU-associated costs in patients with COPD in Finland, according to disease severity and blood eosinophil count (BEC). Patients and methods: This non-interventional, retrospective registry study (GSK ID: HO-17-17558) utilized data from the specialist care hospital register. Data extraction was from first hospital visit with a COPD diagnosis (index date) from January 1, 2004 until December 31, 2015 or death. Patients (aged >18 years with >= 1 report of post-bronchodilation forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio <0.7) were categorized as having non-severe or severe COPD (FEV1 >50% or <= 50% of reference, respectively). Patients who were initially non-severe but progressed to severe were classified as having progressing COPD. Patients without spirometry registry data were classified as having clinically verified COPD. Patients were grouped according to BEC (>= 300 cells/mu L, <300 cells/mu L or BEC unknown). HCRU, estimated associated costs and mortality were evaluated according to COPD severity and BEC. Results: There were 9042 patients with COPD; 340 non-severe, 326 progressing, 394 severe, and 7982 clinically verified. BEC was available for 31.8% of patients. The mean follow-up time was 3.7-6.5 years in the classified patient-groups. All-cause mortality was 46% during follow-up. Severe COPD was associated with more COPD-related HCRU and higher mortality than non-severe COPD. Patients with BEC >= 300 cells/mu L had higher overall HCRU but improved survival compared with those with BEC <300 cells/mu L. Overall direct costs were similar across COPD severity categories, 3300-3900(sic)/patient-year, although COPD-related costs were higher in patients with severe versus non-severe COPD. Conclusion: This study demonstrated a substantial burden associated with severe and/or eosinophilic COPD for patients in Finland.