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Vol. 40. Issue 2.
Pages 72-79 (February 2004)
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Vol. 40. Issue 2.
Pages 72-79 (February 2004)
Original Articles
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Costs of Chronic Obstructive Pulmonary Disease in Spain: Estimation From a Population-Based Study
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J.F. Masaa,
Corresponding author
fmasa@separ.es

Correspondence: Dr. J.F. Masa Jiménez. Rafael Alberti, 12. 1005 Cáceres. España
, V. Sobradillob, C. Villasantec, C.A. Jiménez-Ruizd, L. Fernández-Faue, J.L. Viejof, M. Miravitllesg
a Sección de Neumología, Hospital San Pedro de Alcántara, Cáceres, Spain
b Unidad de Patología Respiratoria, Hospital de Cruces, Baracaldo, Vizcaya, Spain
c Servicio de Neumología, Hospital La Paz, Madrid, Spain
d Servicio de Neumología, Hospital de la Princesa, Madrid, Spain
e Servicio de Cirugía Torácica, Hospital de la Princesa, Madrid, Spain
f Servicio de Neumología, Hospital General Yagüe, Burgos, Spain
g Servicio de Neumología, Hospital Clínic (IDIBAPS), Barcelona, Spain
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Objective

In the studies carried out to date, the cost of chronic obstructive pulmonary disease (COPD) may have been overestimated due to the inclusion of previously diagnosed patients seeking medical attention for their symptoms. As a result, the severity of the cases included in these studies may have been greater than in an unselected sample of the general population. The aim of the present study was to estimate the direct cost of COPD on the basis of a representative sample of the overall Spanish population between 40 and 69 years of age (from the IBERPOC study).

Method

The cost was evaluated retrospectively by means of a questionnaire completed by the 363 patients with COPD from the IBERPOC study with questions referring to the previous year. Standardized spirometry was performed on all the patients by a pneumologist in each of the 7 geographical areas in which the study was carried out.

Results

Hospitalization accounted for the greatest expenditure (41% of total), followed by drug therapy (37%). The cost was €98.39 per patient, and €909.50 per previously diagnosed patient. The cost per person of severe COPD was more than 3 times that of moderate COPD and more than 7 times that of mild COPD. The estimated annual cost of COPD in Spain was €238.82 million (for 1997).

Conclusion

The present study, which was the first to estimate the cost of COPD in a representative sample of the general population, found the cost to be lower than in studies analyzing samples of patients with previous diagnoses of COPD. The cost distribution is not in line with recommended health care practices, underlining the need to optimize resources used to monitor and treat the disease, with an emphasis on early diagnosis.

Key words:
COPD
Costs
Pharmacoeconomics
Treatment
Diagnosis
Epidemiology
Objetivo

En los estudios realizados hasta ahora, el coste de la enfermedad pulmonar obstructiva crónica (EPOC) puede estar sobrestimado porque han incluido a pacientes previamente diagnosticados que consultaron por sus síntomas, por lo que la gravedad puede ser superior a la que realmente tendría una población no seleccionada obtenida de la población general. El propósito del presente estudio fue estimar el coste directo de la EPOC basándose en una muestra representativa del conjunto de la población española de entre 40 y 69 años (estudio IBERPOC).

Método

El coste se evaluó retrospectivamente a través de un cuestionario referido al último año en los 363 pacientes con EPOC del estudio IBERPOC. Un neumólogo realizó a todos ellos una espirometría estandarizada en cada una de las 7 áreas geográficas en las que se llevó a cabo el estudio.

Resultados

La asistencia hospitalaria fue el coste más elevado (41% del coste total), seguido del tratamiento farma-cológico (37%). El coste por paciente fue de 98,39 €, y por paciente previamente diagnosticado, de 909,5 €. El coste de la EPOC grave por persona fue más de tres veces el coste de la EPOC moderada y más de 7 veces el coste de la EPOC leve. El coste anual estimado de la EPOC en España fue de 238,82 millones de euros (información referida a 1997).

Conclusión

Éste es el primer estudio que estima el coste de la EPOC en una muestra representativa de la población general, que es inferior al calculado por los estudios que han analizado una muestra seleccionada con diagnóstico previo de EPOC. La distribución del gasto no se ajusta a las prácticas asistenciales recomendables, por lo que son necesarias actuaciones que optimicen los recursos empleados en el seguimiento y en el tratamiento de la enfermedad, prestando especial atención a su diagnóstico temprano.

Palabras clave:
EPOC
Costes
Farmacoeconomía
Tratamiento
Diagnóstico
Epidemiología
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The IBERPOC study is an initiative of the Assembly on Respiratory Insufficiency and Sleep Disorders (IRTS) of the Spanish Society of Pneumology and Thoracic Surgery (SEPAR).

Funding was obtained from Boehringer Ingelheim Spain, S. A.

Copyright © 2004. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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