The economic burden of asthma and chronic obstructive pulmonary disease and the impact of poor inhalation technique with commonly prescribed dry powder inhalers in three European countries

Lewis, A.; Torvinen, S.; Dekhuijzen, P. N. R.; Chrystyn, H.; Watson, A. T.; Blackney, M.; Plich, A.

doi:10.1186/s12913-016-1482-7

Table 3 Direct and indirect events and costs

From: The economic burden of asthma and chronic obstructive pulmonary disease and the impact of poor inhalation technique with commonly prescribed dry powder inhalers in three European countries

Parameter	Spain		Sweden		UK
Parameter	Frequency (n)	Cost per event (€)^a	Frequency (n)	Cost per event (€)^a	Frequency (n)	Cost per event (€)^a
Annual scheduled healthcare events per person
Asthma
Nurse visits	0.76 [60]	18.99 [61]	0.68 [62]	62.08 [63]	0.85 [64–66]	31.35 [67]
GP visits	2.30 [68]	39.35 [61]	0.68 [62]	152.41 [63]	0.60 [64–66]	75.51 [67]
Specialist visits	2.21 [68]	78.70 [60]	0.34 [62]	206.25 [63]	0.15 [69]^b	133.93 [67]
COPD
Nurse visits	0.76 [60]	18.99 [61]	0.00^c	0.00^c	1.05 [64, 66]	31.35 [67]
GP visits	0.47 [68]	39.35 [61]	1.70 [70]	152.41 [63]	1.30 [64, 66]	75.51 [67]
Specialist visits	1.43 [68]	78.70 [60]	1.70 [70]	206.25 [63]	3.42 [71]	133.93 [67]
Annual unscheduled healthcare events per person
Asthma
Hospitalisations	0.09 [60, 68]	4,495.90 [61, 68]	0.12 [62, 72]^d	748.15 [63, 72]^d	0.02 [72, 73]	1,753.68 [74]
ED visits	0.26 [60, 68]	181.62 [61, 68]	0.20 [75]	177.67 [63]	0.02 [72, 73]	182.12 [74]
Antimicrobial courses	0.70 [76]^e	4.76 [77]	0.50^f	1.07 [78]	0.70 [76]^e	25.65 [79, 80]
OCS courses	0.63 [81]	17.22 [77]	0.20^f	2.34 [78]	0.14 [81]	55.28 [82]
COPD
Hospitalisations	0.26 [60, 68]	3,448.13 [49, 61]	0.38 [70, 72]^d	1,915.26 [63, 72]^d	0.12 [72, 73]	3,554.73 [74]
ED visits	0.08 [60, 68]	181.62 [49, 61]	0.31 [43]	177.67 [63]	0.12 [72, 73]	182.12 [74]
Antimicrobial courses	0.38 [83]	4.76 [77]	2.00^f	1.07 [78]	1.51 [83]	2.94 [84, 85]
OCS courses	0.17 [83]	17.22 [77]	1.60^f	2.34 [78]	0.68 [83]	55.28 [82]
Annual productivity losses per person
Productive days lost (asthma)	12.00 [86, 87]	62.04 [36]	4.00 [62]	205.50 [88]	17.00 [89, 90]	169.22 [91]
Productive days lost (COPD)	24.00^g	62.04 [36]	24.00^g	205.50 [88]	24.00 [73, 92]	169.22 [91]

^aAll cost values are inflated to May 2015 figures, and converted to Euro, where appropriate. ^bData reported by an American cohort study of members of a managed care organisation [69] – assumed to be representative of the UK. ^cPatients with severe COPD in Sweden receive outpatient care from GPs and specialists, and do not visit nurses (based on an interview with a clinical expert).^dCalculated using average length of stay data from UK hospitals [70]. ^eData reported by a study of Irish GP practices [76] – assumed to be representative of Spain and the UK. ^f Values based on the opinion of a clinical expert. ^gData assumed to be the same as reported for the UK. Values are subject to rounding

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ISSN: 1472-6963

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