Cost-effectiveness of antibiotics for COPD management: observational analysis using CPRD data

Area of Science:

• Health Economics
• Respiratory Medicine
• Clinical Practice Research

Background:

• Chronic obstructive pulmonary disease (COPD) exacerbations often have unclear causes, leading to frequent antibiotic prescriptions.
• Determining the cost-effectiveness of antibiotic use in COPD exacerbations is crucial for optimizing healthcare resource allocation.

Purpose of the Study:

• To conduct an observational cost-effectiveness analysis of prescribing antibiotics versus not prescribing them for COPD exacerbations.
• To evaluate the impact of antibiotic prescribing on healthcare resource utilization and patient outcomes.

Main Methods:

• An observational study using electronic health records from 45,375 patients aged 40+ with COPD exacerbations (2000-2013).
• Patients were grouped based on immediate antibiotic prescription or no antibiotics during the index general practice consultation.
• Cost-effectiveness analysis from the UK National Health Service perspective with a 4-week time horizon, extended to 3 and 12 months.

Main Results:

• Antibiotic use for COPD exacerbations resulted in cost savings and improved outcomes.
• The group receiving antibiotics showed lower rates of GP visits, hospitalizations, referrals, and subsequent infections.
• Antibiotic prescribing was found to be dominant over no antibiotic treatment.

Conclusions:

• Prescribing antibiotics for COPD exacerbations is a cost-effective strategy compared to not prescribing them.
• The findings suggest that antibiotic use is beneficial in managing COPD exacerbations from both clinical and economic perspectives.
• Further definitive trials are recommended to confirm the cost-effectiveness of antibiotics for COPD exacerbations.