Smoker Copd Patients Inquire Higher Medication Cost Than Non-Smoker Copd Patients: A 12 Month, Longitudinal, Pharmaco-Economic Analysis

Abstract

A paucity of data in context to economic burden in COPD patients with and without history of smoking exists.  The study evaluated the difference in medication expenditure in COPD patients with and without a history of smoking as an etiological factor.We screened 206 COPD patients treated at the department of respiratory medicine at Chettinad Hospital and Research Institute (CHRI), Kancheepuram, India, and enrolled 180 eligible patients, from August 2019 to July 2020. The baseline information collected during the initial visit includes demographics, smoking status, and respiratory medication regimens, and cost of medications (Inhaler, Oral and Parent Antibiotics and Glucocorticosteroids). Patients were further contacted during their hospital visit or by telephone to collect information on the ongoing treatment, at least 4 times during the study period. A total of  83 (53.20%) with smoking history and and 73 (46.79%) without smoking history competed the study (n=156) with a mean age of 63.03 (SD ±9.11). There was a significant difference in mean annual medication expenditure between non-smoker COPD cohort (INR 9089.74 ± 4502.352) and smoker COPD cohort (INR 12234.82 ± 6553.171), p =0.001. The mean annual expenditure of inhaler medications, antibiotics, and glucocorticosteroids (oral and parental) was INR 8824.86 (SD ± 3464.901), INR 1204.63 (SD ±1950.728), and INR 1415.52 (SD ± 2687.040) in smoker COPD cohort and INR 7244.05 (SD ±1852.400), INR 542.60 (SD ± 1288.121), and INR 686.63 (SD ± 1861.491) in non-smoker COPD cohort respectively (p=0.000; p=0.001; p=0.007). The current study verified that smoker COPD patients incurred significantly higher medication costs than non-smoker COPD patients reiterating the need to study COPD phenotypes further to optimize the treatment regimens.