Economic Impact of Low Adherence to COPD Management Guidelines in Spain

Marc Miravitlles,1 Alexandra Solé,2 Helena Aguilar,3 Ana Ampudia,2 Jaume Costa-Samarra,4 Maria Mallén-Alberdi,4 Diana Nieves4 1Pneumology Department, Vall d’Hebron University Hospital, Vall d’Hebron Research Institute (VHIR), Vall d’Hebron Barcelona Hospital Campus, CIBER for Respiratory Diseases (C...

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Autores principales:	Miravitlles M, Solé A, Aguilar H, Ampudia A, Costa-Samarra J, Mallén-Alberdi M, Nieves D
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	cost chronic obstructive pulmonary disease spanish treatment recommendations Diseases of the respiratory system RC705-779
Acceso en línea:	https://doaj.org/article/2a86a18a923c4712a2598740e1f21919
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spelling	oai:doaj.org-article:2a86a18a923c4712a2598740e1f219192021-11-16T18:47:50ZEconomic Impact of Low Adherence to COPD Management Guidelines in Spain1178-2005https://doaj.org/article/2a86a18a923c4712a2598740e1f219192021-11-01T00:00:00Zhttps://www.dovepress.com/economic-impact-of-low-adherence-to-copd-management-guidelines-in-spai-peer-reviewed-fulltext-article-COPDhttps://doaj.org/toc/1178-2005Marc Miravitlles,1 Alexandra Solé,2 Helena Aguilar,3 Ana Ampudia,2 Jaume Costa-Samarra,4 Maria Mallén-Alberdi,4 Diana Nieves4 1Pneumology Department, Vall d’Hebron University Hospital, Vall d’Hebron Research Institute (VHIR), Vall d’Hebron Barcelona Hospital Campus, CIBER for Respiratory Diseases (CIBERES), Barcelona, Spain; 2Market Access Department of Boehringer Ingelheim SA, Barcelona, Spain; 3Medical Department of Boehringer Ingelheim SA, Barcelona, Spain; 4Oblikue Consulting SL, Barcelona, SpainCorrespondence: Marc MiravitllesPneumology Department, Vall d’Hebron University Hospital, Vall d’Hebron Barcelona Hospital Campus, P. Vall d’Hebron 119-129, Barcelona, 08035, SpainEmail marcm@separ.esObjective: The objective of this study was to assess the non-adherence level of Spanish clinical practice to guideline recommendations for the treatment of chronic obstructive pulmonary disease (COPD) and to estimate the potential impact on pharmaceutical expenditure resulting from transitioning current treatment patterns according to guidelines.Methods: A model was developed to compare current prescribing patterns with two alternative scenarios: the first aligned with the Global Initiative for Chronic Obstructive Lung Disease (GOLD 2020) recommendations, and the second with the Spanish Guidelines for COPD (GesEPOC 2017). Current treatment practice was obtained from publications that describe treatment patterns by pulmonology departments in Spain. The economic impact between patterns was calculated from the perspective of the Spanish National Health System (NHS), considering the annual pharmacological costs of COPD inhaled maintenance therapy. Two additional analyses were performed: one that included current prescribing patterns of patients managed by pulmonology and primary care centers in Spain (published aggregated data); and another that only considered the appropriate use of inhaled corticosteroids (ICS) treatment according to guidelines.Results: It was estimated that 54% and 38% of patients were not treated in line with GOLD and GesEPOC recommendations, respectively, mainly due to a broader use of ICS-based therapies. Adapting treatment to recommendations could provide a potential annual cost-saving of € 17,792,022 (according to GOLD) and € 5,881,785 (according to GesEPOC). In scenario analysis 1, a 26% of non-adherence to GesEPOC guideline was observed with a potential annual pharmacological cost-saving of € 2,707,554. In scenario analysis 2, considering only inappropriate use of ICS treatment, an annual cost-saving of € 17,863,750 (according to GOLD) and € 9,904,409 (according to GesEPOC) was calculated.Conclusion: More than a third of treatments for COPD patients in Spain are not prescribed in accordance with guideline recommendations. The adaptation of clinical practice to guideline recommendations could provide important cost-savings for the Spanish NHS.Keywords: cost, chronic obstructive pulmonary disease, Spanish, treatment, recommendationsMiravitlles MSolé AAguilar HAmpudia ACosta-Samarra JMallén-Alberdi MNieves DDove Medical Pressarticlecostchronic obstructive pulmonary diseasespanishtreatmentrecommendationsDiseases of the respiratory systemRC705-779ENInternational Journal of COPD, Vol Volume 16, Pp 3131-3143 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cost chronic obstructive pulmonary disease spanish treatment recommendations Diseases of the respiratory system RC705-779
spellingShingle	cost chronic obstructive pulmonary disease spanish treatment recommendations Diseases of the respiratory system RC705-779 Miravitlles M Solé A Aguilar H Ampudia A Costa-Samarra J Mallén-Alberdi M Nieves D Economic Impact of Low Adherence to COPD Management Guidelines in Spain
description	Marc Miravitlles,1 Alexandra Solé,2 Helena Aguilar,3 Ana Ampudia,2 Jaume Costa-Samarra,4 Maria Mallén-Alberdi,4 Diana Nieves4 1Pneumology Department, Vall d’Hebron University Hospital, Vall d’Hebron Research Institute (VHIR), Vall d’Hebron Barcelona Hospital Campus, CIBER for Respiratory Diseases (CIBERES), Barcelona, Spain; 2Market Access Department of Boehringer Ingelheim SA, Barcelona, Spain; 3Medical Department of Boehringer Ingelheim SA, Barcelona, Spain; 4Oblikue Consulting SL, Barcelona, SpainCorrespondence: Marc MiravitllesPneumology Department, Vall d’Hebron University Hospital, Vall d’Hebron Barcelona Hospital Campus, P. Vall d’Hebron 119-129, Barcelona, 08035, SpainEmail marcm@separ.esObjective: The objective of this study was to assess the non-adherence level of Spanish clinical practice to guideline recommendations for the treatment of chronic obstructive pulmonary disease (COPD) and to estimate the potential impact on pharmaceutical expenditure resulting from transitioning current treatment patterns according to guidelines.Methods: A model was developed to compare current prescribing patterns with two alternative scenarios: the first aligned with the Global Initiative for Chronic Obstructive Lung Disease (GOLD 2020) recommendations, and the second with the Spanish Guidelines for COPD (GesEPOC 2017). Current treatment practice was obtained from publications that describe treatment patterns by pulmonology departments in Spain. The economic impact between patterns was calculated from the perspective of the Spanish National Health System (NHS), considering the annual pharmacological costs of COPD inhaled maintenance therapy. Two additional analyses were performed: one that included current prescribing patterns of patients managed by pulmonology and primary care centers in Spain (published aggregated data); and another that only considered the appropriate use of inhaled corticosteroids (ICS) treatment according to guidelines.Results: It was estimated that 54% and 38% of patients were not treated in line with GOLD and GesEPOC recommendations, respectively, mainly due to a broader use of ICS-based therapies. Adapting treatment to recommendations could provide a potential annual cost-saving of € 17,792,022 (according to GOLD) and € 5,881,785 (according to GesEPOC). In scenario analysis 1, a 26% of non-adherence to GesEPOC guideline was observed with a potential annual pharmacological cost-saving of € 2,707,554. In scenario analysis 2, considering only inappropriate use of ICS treatment, an annual cost-saving of € 17,863,750 (according to GOLD) and € 9,904,409 (according to GesEPOC) was calculated.Conclusion: More than a third of treatments for COPD patients in Spain are not prescribed in accordance with guideline recommendations. The adaptation of clinical practice to guideline recommendations could provide important cost-savings for the Spanish NHS.Keywords: cost, chronic obstructive pulmonary disease, Spanish, treatment, recommendations
format	article
author	Miravitlles M Solé A Aguilar H Ampudia A Costa-Samarra J Mallén-Alberdi M Nieves D
author_facet	Miravitlles M Solé A Aguilar H Ampudia A Costa-Samarra J Mallén-Alberdi M Nieves D
author_sort	Miravitlles M
title	Economic Impact of Low Adherence to COPD Management Guidelines in Spain
title_short	Economic Impact of Low Adherence to COPD Management Guidelines in Spain
title_full	Economic Impact of Low Adherence to COPD Management Guidelines in Spain
title_fullStr	Economic Impact of Low Adherence to COPD Management Guidelines in Spain
title_full_unstemmed	Economic Impact of Low Adherence to COPD Management Guidelines in Spain
title_sort	economic impact of low adherence to copd management guidelines in spain
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/2a86a18a923c4712a2598740e1f21919
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Economic Impact of Low Adherence to COPD Management Guidelines in Spain

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