Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Apr 19;11(4):e0152618.
doi: 10.1371/journal.pone.0152618. eCollection 2016.

Continuing to Confront COPD International Patient Survey: Economic Impact of COPD in 12 Countries

Jason Foo  1 , Sarah H Landis  2 , Joe Maskell  2 , Yeon-Mok Oh  3 , Thys van der Molen  4 , MeiLan K Han  5 , David M Mannino  6 , Masakazu Ichinose  7 , Yogesh Punekar  8
Affiliations

Continuing to Confront COPD International Patient Survey: Economic Impact of COPD in 12 Countries

Jason Foo et al. PLoS One. .

Abstract

Background: The Continuing to Confront COPD International Patient Survey estimated the prevalence and burden of COPD across 12 countries. Using data from this survey we evaluated the economic impact of COPD.

Methods: This cross-sectional, population-based survey questioned 4,343 subjects aged 40 years and older, fulfilling a case definition of COPD based on self-reported physician diagnosis or symptomatology. Direct cost measures were based on exacerbations of COPD (treated and those requiring emergency department visits and/or hospitalisation), contacts with healthcare professionals, and COPD medications. Indirect costs were calculated from work loss values using the Work Productivity and Activity Impairment scale. Combined direct and indirect costs estimated the total societal costs per patient.

Results: The annual direct costs of COPD ranged from $504 (South Korea) to $9,981 (USA), with inpatient hospitalisations (5 countries) and home oxygen therapy (3 countries) being the key drivers of direct costs. The proportion of patients completely prevented from working due to their COPD ranged from 6% (Italy) to 52% (USA and UK) with 8 countries reporting this to be ≥20%. Total societal costs per patient varied widely from $1,721 (Russia) to $30,826 (USA) but a consistent pattern across countries showed greater costs among those with increased burden of COPD (symptoms, health status and more severe disease) and a greater number of comorbidities.

Conclusions: The economic burden of COPD is considerable across countries, and requires targeted resources to optimise COPD management encompassing the control of symptoms, prevention of exacerbations and effective treatment of comorbidities. Strategies to allow COPD patients to remain in work are important for addressing the substantial wider societal costs.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: This study was funded by GlaxoSmithKline (GSK). SHL and YP are employees of GSK and hold GSK shares. JF was a GSK employee at the time of data analysis and writing and holds shares in GSK. JM is a contingent worker on assignment to GSK. Y-MO, TvdM, MKH, DM, and MI served on the Scientific Advisory Committee for the Continuing to Confront COPD Survey and were paid for advisory services. Scientific Advisory Committee members were not paid for authorship services. The survey was conducted by Abt SRBI, a global survey research firm that specializes in health surveys on behalf of GlaxoSmithKline. There are no patents, products in development or marketed products to declare. This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Annual direct costs per patient of COPD and percentage breakdown by cost type: Continuing to Confront COPD International Patient Survey, 2012–13.
Additional costs not shown: Nursing visits: NL (1%); Influenza vaccination: Brazil (2%); SK (2%); NL (1%); Abbreviations: USA, United States of America, UK, United Kingdom, NL, Netherlands; SK, South Korea
Fig 2
Fig 2. Annual societal costs per patient of COPD in each country (using exchange rates): Continuing to Confront COPD International Patient Survey, 2012–13.
Abbreviations: USA, United States of America, UK, United Kingdom, NL, Netherlands; SK, South Korea
Fig 3
Fig 3. Annual societal per patient cost using exchange rates (Nov 2012 to May 2013) and Purchasing Power Parities (2013) (US$): Continuing to Confront COPD International Patient Survey, 2012–13.
Abbreviations: USA, United States of America, UK, United Kingdom, NL, Netherlands; SK, South Korea
Fig 4
Fig 4. Annual societal costs per patient using exchange rates of COPD stratified by disease and patient characteristics: Continuing to Confront COPD International Patient Survey, 2012–13.
(A) By mMRC grade. (B) By CAT score. (C) By self-perceived severity of COPD. (D) By Comorbidities. Abbreviations: CAT, COPD Assessment Test; mMRC, modified Medical Research Council Scale; USA, United States of America, UK, United Kingdom, NL, Netherlands; SK, South Korea
See this image and copyright information in PMC

References

    1. The Global Initiative for Chronic Obstructive Lung disease (GOLD) revised 2014 www.goldcopd.com.
    1. Agusti AG: COPD, a multicomponent disease: implications for management. Respir Med 2005, 99:670–682. - PubMed
    1. World Health Organisation: Burden of COPD. Last accessed 04 February 2015. http://www.who.int/respiratory/copd/burden/en/
    1. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2095–2128. 10.1016/S0140-6736(12)61728-0 - DOI - PMC - PubMed
    1. Murray CJL, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2197–2223. 10.1016/S0140-6736(12)61689-4 - DOI - PubMed

Publication types