CLINICAL AND PHARMACOECONOMIC PROFILE OF COPD PATIENTS WITH FEV1 50--60% PREDICTED: PILOT STUDY ON THE IMPACT OF THE EXTENDED INDICATION OF ICS/LABA.

teradvrespdes.gifDal Negro RW, Bonadiman L, Turati C, Turco P.

Centro Studi Nazionale di Farmaco-Economia e Farmaco-Epidemiologia Respiratoria, Verona, Italy.

 

BACKGROUND: The use of inhaled corticosteroids (ICS) and long-acting beta(2) adrenergics (LABA) in fixed combination (ICS/LABA) was recently extended to COPD patients with a baseline FEV(1) 50-60% predicted, thus broadening the original guideline indications (GOLD 2006) that limited their use only to stages III and IV.

METHOD: The present study was carried out to assess the clinical profile of this new subset of patients, with a view to providing data for future studies on the impact of this novel extension of ICS/LABA use in COPD.

RESULTS: Data from the present observational cross-sectional study suggest that COPD patients with FEV(1) 50-60% predicted depict a dichotomic condition: actually, even though resembling milder patients in terms of frequency and severity of their respiratory symptoms, they are much more similar to severer patients in terms of rate of hospital admissions and resource consumption (p50.01).

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ASMA E BPCO: I COSTI SOCIALI IN ITALIA

saluterespiro.jpgdi Roberto W. Dal Negro*

* Divisione di Pneumologia, ulss 22 Regione Veneto, Ospedale di Bussolengo, Verona.

 

Asma bronchiale e broncopneumopatia cronica ostruttiva (bpco) rappresentano senza alcun dubbio le patologie cronico-persistenti con la maggior prevalenza ed incidenza in ambito respiratorio.

Tale assunto non è più valido soltanto per i Paesi a modello di sviluppo di tipo “occidentale” poiché anche i Paesi “emergenti” riconoscono da tempo un progressivo ed inarrestabile incremento della prevalenza e dell’incidenza di entrambe queste forme morbose, e soprattutto della bpco (1).

Il controllo dell’andamento quasi epidemico di asma bronchiale e bpco nelle ultime decadi sta ponendo giganteschi problemi medici, gestionali, di politica sanitaria, e socio-economici a livello nazionale ed internazionale, indipendentemente dal modello sanitario localmente adottato.

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COSTS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) IN ITALY: THE SIRIO STUDY (SOCIAL IMPACT OF RESPIRATORY INTEGRATED OUTCOMES).

respiratorymedecine.pngR.W. Dal Negroad, S. Tognellaad, R. Tosattob, M. Dionisib, P. Turcoad,
C.F. Donnercd

(a) Divisione di Pneumologia, Ospedale Orlandi, Bussolengo, Verona, Italy
(b) GlaxoSmtihKline S.p.A., Verona, Italy
(c) Mondomedico, Multidisciplinary and Outpatient Rehabilitation Clinic, Borgomanero, Novara, Italy
(d) CESFAR-Centro Studi Nazionale FISAR di Farmacoeconomia e Farmacoepidemiologia Respiratoria, Verona, Italy


Summary
Chronic respiratory diseases affect a large number of subjects in Italy and are characterized by high socio-health costs. The aim of the Social Impact of Respiratory Integrated Outcomes (SIRIO) study was to measure the health resources consumption and costs generated in 1 year by a population of patients with chronic obstructive pulmonary disease (COPD) in a real-life setting. This bottom-up, observational, prospective, multicentric study was based on the collection of demographic, clinical, diagnostic, therapeutic and outcome data from COPD patients who reported spontaneously to pneumological centers participating in the study, the corresponding economic outcomes being assessed at baseline and after a 1-year survey. A total of 748 COPD patients were enrolled, of whom 561 [408m, mean age 70.3 years (SD 9.2)] were defined as eligible by the Steering Committee. At the baseline visit, the severity of COPD (graded according to GOLD 2001 guidelines) was 24.2% mild COPD, 53.7% moderate and 16.8% severe.

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COSTS OF ASTHMA IN ITALY: RESULTS OF THE SIRIO (SOCIAL IMPACT OF RESPIRATORY INTEGRATED OUTCOMES) STUDY

respiratorymedecine.pngR.W. Dal Negroad, C. Michelettoad, R. Tosattob , M. Dionisib , P. Turcoad,
C.F. Donnercd

(a) Divisione di Pneumologia, Ospedale Orlandi, Bussolengo (VR), Italy
(b) GlaxoSmtihKline S.p.A., Verona, Italy
(c) Mondo Medico, Multidisciplinary and Outpatient Rehabilitation Clinic, Borgomanero (NO), Italy
(d) CESFAR, Centro Studi Nazionale FISAR di Farmacoeconomia e Farmacoepidemiologia Respiratoria, Verona, Italy

Summary
Bronchial asthma is a costly disease and the correlated social impact is ever increasing. The aim of the Social Impact of Respiratory Integrated Outcomes (SIRIO) study was to measure the health resources consumption and the costs generated in 1 year by asthmatic patients investigated in a real-life setting. This bottom–up, observational, prospective, multicentric study was based on the collection of demographic, clinical, diagnostic, therapeutic and outcome data of 577 patients with bronchial asthma who reported spontaneously to the pneumology centers involved in the study. Of these, 485 patients (300 f, mean age 49.2 years±16.3 S.D.) were eligible for analysis. At the baseline visit, the asthma severity was as follows: 26.2% intermittent, 37.1% mild persistent, 29.5% moderate, and 6.6% severe. In the 12 months prior to enrollment, 243 patients (50.1%) had visited the general practitioner (GP); 349 (72%) consulted a National Health Service (NHS) specialist; 68 (14%) utilized Emergency Care; and 50 (10.3%) had been admitted to hospital on account of asthma, with a total of 2059 work days lost.

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HEALTHCARE UTILISATION AND COSTS ASSOCIATED WITH ADDING MONTELUKAST TO CURRENT THERAPY IN PATIENTS WITH MILD TO MODERATE ASTHMA AND CO-MORBID ALLERGIC RHINITIS: PRAACTICAL STUDY.

pharmacoeconomics.gifDal Negro, Roberto (1); Piskorz, Peter (2); Vives, Roberto (3); Guilera, Magda (4); Sazonov Kocevar, Vasilisa (5); Badia, Xavier (4)

(2) Pneumology Department, Outpatients Clinic, Wotomin, Poland
(3) Allergology Department, Hospital 12 Octubre, Madrid, Spain
(4) Health Outcomes Research Europe, Barcelona, Spain
(5) Outcomes Research, Merck & Co., Inc, Whitehouse Station, New Jersey, USA


ABSTRACT

Objective: To evaluate the healthcare resource use and costs associated with adding montelukast to therapy in patients with mild to moderate persistent asthma and co-morbid seasonal allergic rhinitis whose asthma is inadequately controlled by their current asthma therapy.

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OPTIMIZING ECONOMIC OUTCOMES IN THE MANAGEMENT OF COPD

polmoni.jpgRoberto Dal Negro

Lung Dept., Orlandi General Hospital, Bussolengo, Verona Italy;


ABSTRACT

Attention to COPD is increasing worldwide because its high prevalence, morbidity, and mortality present a challenging problem for all healthcare systems. The burden of COPD, which is usually measured in terms of progressive lung function decline, impact on patients’ symptoms, patient’s disability, and quality of life, together with the corresponding use of health care resources, is still a major aspect of the disease.

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