Understanding the economic burden of chronic cough: a systematic literature review

Research  - Open access

Vishal Bali, Ada Adriano, Aidan Byrne, Katherine G. Akers, Andrew Frederickson & Jonathan Schelfhout. BMC Pulmonary Medicine volume 23, Article number: 416 (2023) 

Abstract

Chronic cough (CC) is associated with high healthcare resource utilization (HCRU) due to challenges in diagnosis and treatment and is anticipated to have a substantial economic impact. This systematic literature review (SLR) sought to identify evidence on the cost-effectiveness of treatments and the economic burden associated with CC. Electronic database searches were supplemented with searches of conference proceedings and health technology assessment body websites. Two independent reviewers assessed all citations for inclusion based on predefined inclusion/exclusion criteria. Key inclusion criteria were patient population with CC, and outcomes related to cost-effectiveness and HCRU and costs. After screening, one cost-effectiveness analysis was identified, alongside eight studies reporting HCRU and costs related to CC. Though evidence was limited, studies suggest that patients with CC incur higher costs and use more resources than those with acute cough. Types of resource use reported included healthcare contacts and prescriptions, diagnostic tests, referrals and specialist evaluations, and treatment use. There is a paucity of literature on HCRU and costs in CC, and very limited cost-effectiveness analyses. The economic burden appears higher in these patients however, without direct comparison to the general population it is difficult to determine the total impact. The increased burden is expected to be a result of the challenges with diagnosis and lack of approved treatments. However, limited conclusions can be drawn in the absence of further data. Future studies should endeavor to quantify the HCRU and cost attributable to patients with CC.

Take home message

Patients with CC encounter multiple physicians and specialists to seek a definitive diagnosis, resulting in delayed diagnosis and appropriate treatment. This SLR reported a paucity of economic data; however, it found patients with CC to incur higher costs and more resource use than those with acute cough.

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