Late Breaking Abstract - Assessing epidemiology and costs of asthma and COPD in Switzerland with health insurance data

Background: Asthma and COPD are chronic respiratory diseases with substantial burden. Only appropriate treatment and disease management can reduce symptoms and treatment costs. Such evidence is sparse though, especially in Switzerland. Objective: To assess the costs of asthma and COPD by severity according to GINA and GOLD treatment guidelines in Switzerland. Methods: We used 2016 Swiss health insurance data. Patients were identified as asthma and COPD patients if they had received at least one drug of the R03 group in the ATC drug classification. Differentiation between asthma and COPD patients was carried out in two steps: First, patients were directly assigned to one or the other disease based on disease specific drugs, inpatient diagnoses, age, medical examinations and devices. Second, a statistical model was developed to classify patients that could not be classified in the first step. Disease severity was assessed based on medication. GINA and GOLD treatment steps served as proxy for disease severity. Results: Prevalence of treated asthma was estimated at 5.1% to 6.4% and at 2.6% to 4.5% for COPD in patients over the age of 30. Directs medical costs were estimated at 137m to 175m Euro for asthma and at 165m to 204m Euro for COPD. Indirect costs were estimated at 217m to 280m Euro for asthma and 204m to 677m Euro for COPD. Costs were increasing with severity for both diseases. Conclusions: This is the first study using Swiss health insurance data in this context. Such data are highly valuable because of their high accuracy. Evidence on severity distribution and corresponding costs may help identify weaknesses in treatment and reduce costs by attaining better disease control.