Clinical and economic burden of patients diagnosed with COPD with comorbid cardiovascular disease

Background: Cardiovascular disease (CVD) and chronic obstructive pulmonary disease (COPD) commonly coexist, increasing the risk of hospitalization and mortality compared to either condition alone. The purpose of this study was to evaluate the impact of comorbid CVD on healthcare utilization and costs in a COPD population. Methods: A retrospective cohort study of COPD patients CVD +/- >= 40 years of age using administrative claims data was conducted. COPD-CVD patients were matched to COPD patients without CVD (COPD-Only cohort) using propensity scores. Multivariate analyses were conducted to assess the 1-year risk of COPD exacerbations (hospitalization and/or emergency room [ER] visits), along with differences in 1-year and 2-year all-cause and COPD-related utilization and costs (2008 USD) among COPD-CVD and COPD-Only cohorts. Results: Each cohort included 4594 patients. Compared to COPD-Only cohort, the COPD-CVD cohort was almost 2 times more likely to require COPD-related hospitalization (odds ratio [OR], 1.95; p < 0.001), 47% more likely to have an ER visit (OR, 1.47; p < 0.001) and 62% more likely to require hospitalization and/or ER visit (OR, 1.62; p < 0.001). Average annual all-cause medical costs per patient were $22,755 for COPD-CVD vs $8036 for COPD-Only (p < 0.001), and total costs were $27,032 vs $11,506 (p < 0.001), respectively; corresponding average COPD-related annual medical costs were $1891 vs $1060 (p < 0.001) and total costs were $3295 vs $2379 (p < 0.001). Conclusions: COPD patients with CVD have significantly higher risk of COPD exacerbations and increased costs than COPD patients without CVD. This suggests a close association between COPD and CVD that warrants further exploration. (C) 2011 Published by Elsevier Ltd.