Healthcare costs of patients with COPD on maintenance inhaled therapies between 2011 and 2019 in Hungary

Chronic obstructive pulmonary disease (COPD) poses a major economic burden on healthcare systems, however, data on costs in Eastern Europe are lacking. We aimed to analyse treatment costs of patients with COPD on maintenance inhaled therapy in Hungary between 2011 and 2019. A longitudinal, retrospective analysis of the database of the Hungarian National Health Insurance Fund was conducted on patients >40 years old on COPD maintenance inhaled therapy prescribed with J41-44 ICD codes between 2011 and 2019. Data regarding age, sex, comorbidities (Charlson comorbidity index), inhaled therapy, and medical costs were collected. Influencing factors were analysed using a linear mixed model, and the risk expressed as odds ratio (OR). We analysed the data of 227 251 patients. In 2019, total and COPD-related costs were 401.15 and 118.14 million USD, respectively. Between 2011 and 2019, total and COPD-related health expenditures per patient increased by 23.1% and 5.8%, respectively. In each year, the highest expenditures were hospital care and medications. The number of hospitalizations due to COPD (p<0.001) and age positively influenced (p<0.001), while female sex was associated with reduced risk of total and COPD-related costs (OR 0.97 and 0.95, respectively, p<0.001). Comorbidity burden was related to increased risk of total costs (moderate-burden: OR 1.57, high-burden: OR 2.34, p<0.001), but not to COPD-related costs. The duration of inhaled maintenance therapy, as assessed by the redeemed prescriptions, was associated with increased total and COPD-related costs. In conclusion, our data can aid the development of strategies to reduce the healthcare costs of patients with COPD.