Objectives
To investigate epidemiology, concomitant sinus polyps, spirometry supply and cost of patients with obstructive airway disease (OAD), in the Italian National Health System (NHS) perspective.
Methods
From the ReS database, patients with OAD were selected in 2015 (accrual) through administrative data record linkage. They were further split into subjects with asthma, chronic obstructive pulmonary disease (COPD), asthma-COPD, undefined. The first two specific cohorts are presented. At the index date (i.e. the less recent identifying event among drug prescription, hospitalization, outpatient specialist service), subjects were characterized by gender and age. Sinus polyps hospitalization diagnoses (ICD9 code) were searched in the accrual, previous year and 2-year follow-up. One-year outpatient spirometry tests were identified. Two-year healthcare costs in the NHS perspective, from reimbursed drugs, hospitalizations and outpatient specialist care integration, were assessed annually.
Results
Out of >7 million inhabitants in the 2015 ReS database, asthma cohort was made of patients aged ≥12 years (prevalence 16.6 x1,000), while COPD of people aged ≥40 years (prevalence 55.5 x1,000). Asthma prevalence was higher in women, whereas COPD in men. Sinus polyps hospital diagnoses occurred more frequently among asthma patients than COPD ones (6.8 x1,000 vs 0.8 x1,000), with males dominating. During 1-year follow-up, spirometry tests occurred at least once to 9.2% of asthma subjects and to 8.6% of COPD ones, mostly among men. In the first year, the overall mean cost per asthma patient was €942, while €3,508 per COPD subject. On average, pharmaceuticals costed €545 and €1,450, hospitalizations €223 and €1.498, outpatient care €174 and €560, per asthma and per COPD patient respectively, without changing in the 2nd year.
Conclusions
This real-world observational study showed the real impact of OAD in Italy on the NHS, estimated the target population of unmet clinical needs (e.g. sinus polyps) and confirmed the well-known spirometry test underuse.
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