Milewska A, Rysiak E, Zareba I, Holownia A, Mroz R M
Respiratory Medicine Center, 9a Piasta St., 15-044, Bialystok, Poland.
Department of Medicinal Chemistry, Bialystok Medical University, 2d Mickiewicza St., 15-222, Bialystok, Poland.
Adv Exp Med Biol. 2016;885:67-75. doi: 10.1007/5584_2015_199.
The aim of this study was to analyze direct costs of COPD therapy in relation with clinical course and stage of the disease. Sixty patients with moderate to severe COPD were included into the study. The average cost was taken from institutional data file and was also assessed from a social perspective. Results were presented as average costs per patient per year. Forty two percent of patients was classified as GOLD D category, while categories A, B, and C accounted for 8 %, 27 %, and 23 %, respectively. Approximately 65 % of patients had 2-3 degrees of dyspnea according to the Modified Medical Research Council Dyspnea Scale. About 60 % of patients underwent two or three exacerbations per year and those patients had one or two co-morbidities diagnosed. Treatment costs almost doubled with disease progression, mainly due to exacerbations. In patients in Group C and Group D with exacerbations the direct costs were several times higher than in group A or B and the difference increased with progression of the disease. In Groups A and B, the costs of treatment of stable disease or with exacerbation were comparable. We conclude that costs of treatment of COPD patients were highest in advanced disease and were strongly related to COPD exacerbations.
本研究旨在分析慢性阻塞性肺疾病（COPD）治疗的直接成本与疾病临床进程及阶段的关系。60例中重度COPD患者纳入本研究。平均成本取自机构数据文件，并从社会角度进行评估。结果以每位患者每年的平均成本呈现。42%的患者被归类为GOLD D级，而A、B和C级分别占8%、27%和23%。根据改良医学研究委员会呼吸困难量表，约65%的患者有2 - 3级呼吸困难。约60%的患者每年经历2 - 3次病情加重，且这些患者被诊断有一种或两种合并症。治疗成本随疾病进展几乎翻倍，主要原因是病情加重。在病情加重的C组和D组患者中，直接成本比A组或B组高出数倍，且随着疾病进展差异增大。在A组和B组中，稳定期疾病或病情加重时的治疗成本相当。我们得出结论，COPD患者的治疗成本在疾病晚期最高，且与COPD病情加重密切相关。
