Health care resource utilization and costs following acute exacerbation of copd and associated cardiovascular events in a large us claims database: the exacos-cv study

SESSION TITLE: Obstructive Lung Disease Posters 6 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/11/2023 12:00 pm - 12:45 pm PURPOSE: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has been associated with an increased risk of acute cardiovascular (CV) events and healthcare resource use (HCRU); however, data are limited. This study evaluated healthcare costs and HCRU following an AECOPD and assessed the contribution of CV-related care. METHODS: Patients ≥40 years old with an incident COPD diagnosis between January 1, 2012-December 31, 2019, were identified using the HealthCare Integrated Research Database, a large US healthcare claims database. AECOPD was defined as an outpatient COPD diagnosis with a prescription for antibiotics or glucocorticoids (moderate), inpatient or emergency department (ED) diagnosis of COPD (severe), or an inpatient or ED diagnosis of lower respiratory infection with secondary diagnosis of COPD (severe). The index date was the date of first AECOPD; follow-up ended at disenrollment, subsequent AECOPD, death, or end of study period. Costs (plan and patient-paid) and HCRU (inpatient hospitalization, outpatient and ED visits, and prescriptions) were measured 1 month and 2-12 months post-index. Data were analyzed overall and by subgroup (patients with or without an acute CV event ≤12 months post-index). RESULTS: 145,838 patients (41% of cohort) experienced at least one AECOPD; 85.3% moderate and 14.6% severe. Mean (median) costs at 1-month post-AECOPD were 5.6x higher for those with a severe AECOPD ($36,273 [$11,210]) vs. moderate ($6,474 [$824]) and were primarily driven by inpatient hospitalization (5.2% of patients with moderate and 52.3% of patients with severe AECOPD had ≥1 hospitalization). Overall, 12-month mean (median) costs were 1.8x more for patients with versus those without a CV event ($16,340 [$5,474] vs. $9,195 [$898]). CONCLUSIONS: HCRU was higher among patients experiencing severe AECOPD and subsequent CV events. These results highlight the burden of AECOPD events and the subsequent increased cost and HCRU associated with this cardiopulmonary risk. CLINICAL IMPLICATIONS: The high HCRU and costs associated with AECOPD should inform COPD management approaches for both payers and providers and highlight the importance of indexing cardiovascular risk in all subjects with COPD prone to acute exacerbations. DISCLOSURES: Consultant relationship with Pulmonx Please note: $1-$1000 by Gerard Criner, value=Consulting fee Consultant relationship with Medtronic Please note: $1-$1000 by Gerard Criner, value=Consulting fee Consultant relationship with Merck Please note: $1-$1000 by Gerard Criner, value=Consulting fee Consultant relationship with Mereo BioPharma Please note: $1-$1000 by Gerard Criner, value=Consulting fee Consultant relationship with NGM Pharmaceuticals Please note: $1-$1000 by Gerard Criner, value=Consulting fee Consultant relationship with Novartis Please note: $1-$1000 by Gerard Criner, value=Consulting fee Consultant relationship with Nuvaira Please note: $1-$1000 by Gerard Criner, value=Consulting fee Consultant relationship with Olympus Please note: $1-$1000 by Gerard Criner, value=Consulting fee Consultant relationship with Philips Respironics Please note: $1-$1000 by Gerard Criner, value=Consulting fee Consultant relationship with Helios Medical Please note: $1-$1000 by Gerard Criner, value=Consulting fee Consultant relationship with Respivant Sciences Please note: $1-$1000 by Gerard Criner, value=Consulting fee Consultant relationship with The Implementation Group Please note: $1-$1000 by Gerard Criner, value=Consulting fee Consultant relationship with Verona Please note: $1-$1000 by Gerard Criner, value=Consulting fee Shareholder relationship with HGE Technologies Please note: $1-$1000 by Gerard Criner, value=Shares Advisory Committee Member relationship with Boehringer Ingelheim Please note: $1001 - $5000 by Gerard Criner, value=Honoraria Advisory Committee Member relationship with GSK Please note: $1001 - $5000 by Gerard Criner, value=Consulting fee Consultant relationship with pulmonx Please note: $1-$1000 by Gerard Criner, value=Consulting fee Consultant relationship with AstraZeneca Please note: $1-$1000 by Gerard Criner, value=Consulting fee Advisory Committee Member relationship with rested Please note: $1001 - $5000 by Gerard Criner, value=Grant/Research Support Advisory Committee Member relationship with respironics Please note: $1001 - $5000 by Gerard Criner, value=Consulting fee Consultant relationship with CSA medical Please note: $1001 - $5000 by Gerard Criner, value=Grant/Research Support Advisory Committee Member relationship with gala Please note: $1001 - $5000 by Gerard Criner, value=Consulting fee Consultant relationship with astra zeneca Please note: $1001 - $5000 by Gerard Criner, value=Consulting fee Consultant relationship with olympus Please note: $1001 - $5000 by Gerard Criner, value=Consulting fee Consultant relationship with Almirall Please note: $1-$1000 by Gerard Criner, value=Consulting fee Consultant relationship with Amgen Please note: $1-$1000 by Gerard Criner, value=Consulting fee Consultant relationship with Boehringer Ingelheim Please note: $1-$1000 by Gerard Criner, value=Consulting fee Consultant relationship with Broncus Medical Please note: $1-$1000 by Gerard Criner, value=Consulting fee Consultant relationship with Chiesi Please note: $1-$1000 by Gerard Criner, value=Consulting fee Consultant relationship with CSA Medical Please note: $1-$1000 by Gerard Criner, value=Consulting fee Consultant relationship with Eolo Please note: $1-$1000 by Gerard Criner, value=Consulting fee Consultant relationship with Gala Therapeutics Please note: $1-$1000 by Gerard Criner, value=Consulting fee Consultant relationship with GSK Please note: $1-$1000 by Gerard Criner, value=Consulting fee Consultant relationship with AstraZeneca Please note: 2021-current Added 03/31/2023 by Kimberly Daniels, source=Web Response, value=Grant/Research Support Consultant relationship with AbbVie Please note: 2020-current Added 03/31/2023 by Kimberly Daniels, source=Web Response, value=Grant/Research Support Consultant relationship with Pfizer Please note: 2020-current Added 03/31/2023 by Kimberly Daniels, source=Web Response, value=Grant/Research Support Employee relationship with AstraZeneca Pharmaceuticals LP Please note: >$100000 by Norbert Feigler, value=Salary No relevant relationships by Stephan Lanes Employee relationship with GlaxoSmithKline Please note: >$100000 by David Mannino, value=Salary Removed 04/01/2023 by David Mannino, source=Web Response Employee relationship with GSK Please note: 8/2017-9/2020 by David Mannino, value=Salary Removed 04/01/2023 by David Mannino, source=Web Response Consultant relationship with COPD Foundation Please note: 11/2020 - present by David Mannino, value=Salary Consultant relationship with AstraZeneca Please note: 1/21 to present Added 04/01/2023 by David Mannino, source=Web Response, value=Consulting fee Consultant relationship with GlaxoSmithKline Please note: 1/22 to present Added 04/01/2023 by David Mannino, source=Web Response, value=Consulting fee No relevant relationships by Amanda Neikirk Employee relationship with AstraZeneca Please note: >$100000 by Michael Pollack, value=Salary Employee relationship with Astrazeneca Please note: 4.5 years Added 03 /31 /2023 by Kirsty Rhodes, value=Salary
更多