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

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.

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. 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. 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. 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