Incremental Direct Cost of Chronic Obstructive Pulmonary Disease in Colombia Using Doubly Robust Methods on...

To estimate incremental healthcare costs associated with chronic obstructive pulmonary disease (COPD) using administrative healthcare data in Colombia.

We conducted a retrospective cohort analysis using administrative health databases from Colombia's population covered by the contributory health insurance scheme. Patients with COPD were identified using a specific operative definition, and the control group was randomly selected from the remaining individuals. To estimate the incremental cost of COPD, we applied a causal approach using a doubly robust model, integrating propensity scores and outcome regression models. This ensured accurate estimation by addressing potential confounding, being robust for misspecification both in the propensity score and in the mean outcome. Confidence intervals were obtained using bootstrapping. In addition, we analyzed the incremental effect of common COPD complications, such as cardiovascular diseases and pulmonary infections.

Our group of patients with COPD was comprised 251 060 people, whereas our control group comprised 967 081 people. The estimated incremental cost of a person with COPD was US dollars $1349. The incremental cost of a person with COPD and some type of complication ranged from $1405 to $2935. The most expensive complication was lung cancer, and the least expensive complication was any type of muscular weakness.

The incremental costs of COPD in Colombia align with the average values typically reported for middle-income countries. However, these estimates fall on the lower end of global cost estimations. There was a greater incremental cost found for patients with complications such as lung cancer, cardiovascular diseases, and pulmonary infections.