Izquierdo-Alonso José Luis, de Miguel-Díez J
Section of Pneumology, Hospital General Universitario de Guadalajara, Guadalajara, Spain.
COPD. 2004;1(2):215-23. doi: 10.1081/copd-120039809.
To assess the impact of prescribing pulmonary drugs according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines on direct costs in stable chronic obstructive pulmonary disease (COPD).
A total of 560 ambulatory COPD patients completed a specific questionnaire that included data regarding drug therapy. Severity was graded according to the British Thoracic Society (BTS) criteria and appropriateness of pharmacological treatment according to GOLD guidelines.
Annual direct costs were 1,657 EUR in stage I, 2,425 EUR in stage II, and 3,303 EUR in stage III. The mean direct costs was 2,061 EUR (38% corresponded to drug therapy). Medication accounted for 43%, 37.6%, and 28.4% of total direct costs for stage I, II, and III, respectively. Inhaled steroids and long-acting beta2-agonists accounted for 78%, 76%, and 75% of total drugs costs in stages I, II, and III, respectively. Drug therapy which was not in accordance with guidelines accounted for 78.7% and 54% of total drug costs in stages I and II, respectively. Most patients with severe disease were treated adequately. ANSWER TO THE QUESTION: Pharmacologic treatment has a great impact on direct medical costs in stable COPD. According to GOLD guidelines, patients with mild or moderate COPD are frequently treated with nonrecommended drugs.
评估根据慢性阻塞性肺疾病全球倡议（GOLD）指南开具肺部药物对稳定期慢性阻塞性肺疾病（COPD）直接费用的影响。
共有560例门诊COPD患者完成了一份特定问卷，其中包括药物治疗相关数据。根据英国胸科学会（BTS）标准对疾病严重程度进行分级，并根据GOLD指南评估药物治疗的合理性。
I期患者的年度直接费用为1657欧元，II期为2425欧元，III期为3303欧元。平均直接费用为2061欧元（38%为药物治疗费用）。药物治疗分别占I期、II期和III期总直接费用的43%、37.6%和28.4%。吸入性糖皮质激素和长效β2受体激动剂分别占I期、II期和III期药物总费用的78%、76%和75%。不符合指南的药物治疗分别占I期和II期药物总费用的78.7%和54%。大多数重症患者得到了充分治疗。
药物治疗对稳定期COPD的直接医疗费用有很大影响。根据GOLD指南，轻度或中度COPD患者经常使用未推荐的药物进行治疗。
