High risk COPD patients cost less if treated according to GOLD 2011 recommendations

Introduction The latest GOLD 2011 recommendations provide an opportunity for a more patient oriented therapeutic approach. Aim This prospective 1-year, follow-up study attempted to determine the direct cost and the cost of associated comorbidities derived from the management of COPD patients hospitalized for an exacerbation. Methods A total of 88 (70 male and 18 female) high risk (groups C and D) COPD patients were recruited. Comorbidities and treatment were searched by history, previous medical papers and by performing clinical examinations. All direct medical costs incurred by the cohort were calculated. Results The mean direct 1-year hospitalization cost for COPD patients was €763. From all patients, 67% were treated according to GOLD 2011 recommendations (Group R – mean cost €788) and 37% - not (Group NR = €712), p<0.05. Comorbidities were found in 80,7% (71) of all. The patients without comorbidities in Group R (64.7%, mean age 67.1 [SD ±9], mean FEV1 - 38,7% of predicted value, hospitalizations per year – 2.45) generated €528, those in Group NR (35.3%, mean age 67 SD ±10, FEV1 – 35.3%, hospitalization per year 2.17) - €608, p<0.05. Conclusion Costs of comorbidities raise the total mean cost. Mean cost in group R is found to be higher – because of the frequency and the severity of the comorbidities. Patients without comorbidities in group R generated less expenses (-13,2%), compared to group NR.