Late Breaking Abstract - Assessing epidemiology and costs of asthma and COPD in Switzerland with health insurance data

M. Schmidt, B. Brunner, S. Wieser, R. Rapold, E. Blozik
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Abstract

Background: Asthma and COPD are chronic respiratory diseases with substantial burden. Only appropriate treatment and disease management can reduce symptoms and treatment costs. Such evidence is sparse though, especially in Switzerland. Objective: To assess the costs of asthma and COPD by severity according to GINA and GOLD treatment guidelines in Switzerland. Methods: We used 2016 Swiss health insurance data. Patients were identified as asthma and COPD patients if they had received at least one drug of the R03 group in the ATC drug classification. Differentiation between asthma and COPD patients was carried out in two steps: First, patients were directly assigned to one or the other disease based on disease specific drugs, inpatient diagnoses, age, medical examinations and devices. Second, a statistical model was developed to classify patients that could not be classified in the first step. Disease severity was assessed based on medication. GINA and GOLD treatment steps served as proxy for disease severity. Results: Prevalence of treated asthma was estimated at 5.1% to 6.4% and at 2.6% to 4.5% for COPD in patients over the age of 30. Directs medical costs were estimated at 137m to 175m Euro for asthma and at 165m to 204m Euro for COPD. Indirect costs were estimated at 217m to 280m Euro for asthma and 204m to 677m Euro for COPD. Costs were increasing with severity for both diseases. Conclusions: This is the first study using Swiss health insurance data in this context. Such data are highly valuable because of their high accuracy. Evidence on severity distribution and corresponding costs may help identify weaknesses in treatment and reduce costs by attaining better disease control.
摘要:用健康保险数据评估瑞士哮喘和慢性阻塞性肺病的流行病学和成本
背景:哮喘和慢性阻塞性肺病是负担沉重的慢性呼吸系统疾病。只有适当的治疗和疾病管理才能减少症状和治疗费用。然而,这样的证据很少,尤其是在瑞士。目的:根据瑞士GINA和GOLD治疗指南,按严重程度评估哮喘和COPD的成本。方法:我们使用2016年瑞士健康保险数据。如果患者接受了ATC药物分类中R03组中至少一种药物,则确定为哮喘和COPD患者。区分哮喘和COPD患者分两步进行:首先,根据疾病特异性药物、住院诊断、年龄、医疗检查和设备,将患者直接分配到一种或另一种疾病。其次,建立统计模型,对第一步无法分类的患者进行分类。疾病严重程度是根据药物来评估的。GINA和GOLD治疗步骤作为疾病严重程度的代表。结果:在30岁以上的患者中,经治疗的哮喘患病率估计为5.1%至6.4%,COPD患病率为2.6%至4.5%。哮喘的直接医疗费用估计为1.37亿至1.75亿欧元,慢性阻塞性肺病的直接医疗费用估计为1.65亿至2.04亿欧元。哮喘的间接成本估计为2.17亿至2.8亿欧元,慢性阻塞性肺病的间接成本估计为2.04亿至6.77亿欧元。这两种疾病的治疗费用都随着严重程度的增加而增加。结论:这是在此背景下首次使用瑞士健康保险数据的研究。这些数据因其准确性高而具有很高的价值。关于严重程度分布和相应费用的证据可能有助于查明治疗方面的弱点,并通过更好地控制疾病来降低费用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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