Economic burden of diagnosed pertussis among individuals with asthma or chronic obstructive pulmonary disease in the USA: an analysis of administrative claims

Abstract

Individuals with chronic respiratory conditions may be at increased risk for pertussis. We conducted a retrospective administrative claims analysis to examine the incidence and economic burden of diagnosed pertussis among adolescents and adults in the USA with chronic obstructive pulmonary disease (COPD) or asthma. Patients aged ⩾11 years with diagnosed pertussis and pre-existing COPD (n = 343) or asthma (n = 1041) were matched 1:1 to patients with diagnosed pertussis but without COPD or asthma. Differences in all-cause costs ('excess' costs) during the 45-day and 3-month and 6-month periods before and after the pertussis index date were calculated; adjusted excess costs were estimated via multivariate regressions. The incidence of diagnosed pertussis was higher among patients with COPD or asthma than among matched patients. Compared with matched patients, patients with pertussis and pre-existing COPD or asthma accrued greater all-cause adjusted costs across study periods ($3694 and $1193 more, respectively, in the 45-day period; $4173 and $1301 more in the 3-month period; and $6154 and $1639 more in the 6-month period; all P < 0·0001). Patients with pre-existing COPD or asthma experience an increased economic burden after diagnosed pertussis and may especially benefit from targeted tetanus, diphtheria, and acellular pertussis vaccination strategies.

Keywords: Asthma; chronic obstructive pulmonary disease; economic burden; pertussis; retrospective database analysis.

Conflict of interest statement

P.O.B. and L.-D.G. are employees of the GSK group of companies. P.O.B. owns shares in the GSK group of companies as part of his employee remuneration. J.L.M., R.P., S.K.K., and K.L.D. are employees of RTI Health Solutions, which received funding from the GSK group of companies for the conduct of the study. S.K.K. has received contract research funding from Eli Lilly, Pfizer Inc., and LEO Pharma, and K.L.D. has received contract research funding from Merck through their institution.

Figures

Fig. 1.

Adjusted all-cause health care costs for patients with pre-existing COPD and pertussis and matched patients with pertussis only in the 45 days, 3 months, and 6 months following the index date. COPD = chronic obstructive pulmonary disease. *P < 0·0001 for all differences.

Fig. 2.

Adjusted all-cause health care costs for patients with pre-existing asthma and pertussis and matched patients with pertussis only in the 45 days, 3 months, and 6 months following the index date. *P < 0·0001 for all differences.

Fig. 3.

Adjusted pertussis-related health care costs for patients with pre-existing COPD and pertussis and matched patients with pertussis only in the 45 days, 3 months, and 6 months following the index date. COPD = chronic obstructive pulmonary disease. *P < 0·0001 for all differences.

Fig. 4.

Adjusted pertussis-related health care costs for patients with pre-existing asthma and pertussis and matched patients with pertussis only in the 45 days, 3 months, and 6 months following the index date. *P < 0·0001 for all differences.