Costs and health-related quality of life in Alpha-1-Antitrypsin Deficient COPD patients

Respiratory Research

Research

Robert Bals¹  Timm Greulich²  Claus Vogelmeier²  Rudolf A. Jörres³  Stefan Karrasch⁴  Annika Karch⁵  Armin Koch⁵  Holger Schulz⁶  Reiner Leidl⁷  Rolf Holle⁷  Margarethe E. Wacker⁷  Florian M. Karl⁸ 

[1] Department of Internal Medicine V – Pulmonology, Allergology, Respiratory Intensive Care Medicine, Saarland University Hospital, Kirrberger Straße 1, 66424, Homburg, Germany;Department of Respiratory Medicine, University of Marburg, University Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research, Baldingerstraße, 35043, Marburg, Germany;Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-Universität München, Ziemssenstr. 1, 80336, Munich, Germany;Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-Universität München, Ziemssenstr. 1, 80336, Munich, Germany;Institute of Epidemiology I, Helmholtz Zentrum München, GmbH, German Research Center for Environmental Health, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany;Institute for Biostatistics, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany;Institute of Epidemiology I, Helmholtz Zentrum München, GmbH, German Research Center for Environmental Health, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany;Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, GmbH, German Research Center for Environmental Health, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany;Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, GmbH, German Research Center for Environmental Health, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany;Institute for Medical Information Processing Biometrics and Epidemiology (IBE) Ludwig-Maximilians-Universität München (LMU), Marchioninistr. 15, 81377, Munich, Germany;

关键词: COPD;    Alpha-1-Antitrypsin Deficiency;    Direct costs;    Indirect costs;    Health-related quality of life;    Augmentation therapy;   

DOI  :  10.1186/s12931-017-0543-8

 received in 2017-01-12, accepted in 2017-04-05,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundAlpha-1-Antitrypsin Deficiency (AATD) is an economically unexplored genetic disease.MethodsDirect and indirect costs (based on self-reported information on healthcare utilization) and health-related quality of life (HRQL, as assessed by SGRQ, CAT, and EQ-5D-3 L) were compared between 131 AATD patients (106 with, 25 without augmentation therapy (AT)) and 2,049 COPD patients without AATD participating in the COSYCONET COPD cohort. The medication costs of AT were excluded from all analyses to reveal differences associated with morbidity profiles. The association of AATD (with/without AT) with costs or HRQL was examined using generalized linear regression modelling (GLM) adjusting for age, sex, GOLD grade, BMI, smoking status, education and comorbidities.ResultsAdjusted mean direct annual costs were €6,099 in AATD patients without AT, €7,117 in AATD patients with AT (excluding costs for AT), and €7,460 in COPD patients without AATD. AATD with AT was significantly associated with higher outpatient (+273%) but lower inpatient (−35%) and medication costs (−10%, disregarding AT) compared with COPD patients without AATD. There were no significant differences between groups regarding indirect costs and HRQL.ConclusionApart from AT costs, AATD patients tended to have lower, though not significant, overall costs and similar HRQL compared to COPD patients without AATD. AT was not associated with lower costs or higher HRQL.Trial registrationNCT01245933

【 授权许可】

CC BY   
© The Author(s). 2017