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
. 2021 Mar 10:16:603-613.
doi: 10.2147/COPD.S295388. eCollection 2021.

Economic Burden of COPD by Disease Severity - A Nationwide Cohort Study in Denmark

Anders Løkke  1   2 , Peter Lange  3   4 , Jesper Lykkegaard  5 , Rikke Ibsen  6 , Maria Andersson  7 , Sofie de Fine Licht  8 , Ole Hilberg  1   2
Affiliations

Economic Burden of COPD by Disease Severity - A Nationwide Cohort Study in Denmark

Anders Løkke et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) carries a considerable economic burden, both for individuals and societies. This study aimed to assess direct and indirect costs associated with COPD, and how costs vary across disease severity.

Methods: This was a nationwide, population-based cohort study utilizing Danish health registries. Patients; ≥40 years of age, with an in- and/or outpatient diagnosis of COPD (ICD-10 J44) in 2008-2016, were identified in the nationwide Danish COPD Registry. Included patients were matched 1:4 to a population-based non-COPD reference population of 196,623 individuals by sex, year of birth, co-habitation status, and municipality. Patients were grouped by disease severity according to different characteristics including GOLD groups A-D, based on moderate (short-term oral corticosteroid use), presence of severe exacerbations (emergency visit or hospitalization) and symptom score. Index was the date of the first outpatient visit with a symptom score registration. The costs were calculated during a 12 months post-index follow-up.

Results: In all, 49,826 patients with COPD (mean age 69.2 years, 52% females) were included. Total annual costs, including direct costs, costs for elderly care, and costs for retirement home, were higher for patients with COPD (€28,969) compared with the reference population (€10,6913). In GOLD groups A-D, the total direct costs were A: €8,766, B: €13,060, C: €11,113, and D: €17,749, respectively. A major driver of direct costs was severe exacerbations. The mean costs per moderate and severe exacerbation were €888 and €7,091, respectively, during 28 days of follow-up. The costs for non-COPD-related Health Care Resource Utilization were higher than the COPD-related costs in GOLD groups A-C, but not in GOLD group D.

Conclusion: In this nationwide real-world study, total direct costs were three-fold higher among patients with COPD compared with the reference population. Severe exacerbations were a major driver of the direct costs. The costs increased with increasing disease severity.

Keywords: COPD; GOLD; cost; exacerbations; symptoms.

PubMed Disclaimer

Conflict of interest statement

A.L., J.L., R.I., and O.H. report no conflict of interests in relations to the current study. P.L. has participated in advisory boards for AstraZeneca, Boehringer Ingelheim, Chiesi and GSK, and has received research grants from AstraZeneca, Boehringer Ingelheim and GSK. M.A. and S.dFL. are full-time employees of AstraZeneca. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Diagram showing flow of study participants and final study cohort size.
Figure 2
Figure 2
Direct costs in euro (€) in COPD patients, presented as COPD-related and non-COPD-related costs and stratified by GOLD group.
See this image and copyright information in PMC

References

    1. ERS - Respiratory health and disease in Europe. Available from: https://www.erswhitebook.org/. Accessed June21, 2020.
    1. Forum of International Respiratory Societies. The Global Impact of Respiratory Disease. 2nd ed. Sheffield: European Respiratory Society, Forum of International Respiratory Societies; 2017.
    1. Guarascio AJ, Ray SM, Finch CK, Self TH. The clinical and economic burden of chronic obstructive pulmonary disease in the USA. Clin Outcomes Res. 2013;5:235–245. - PMC - PubMed
    1. Løkke A, Fabricius PG, Vestbo J, Marott JL, Lange P. Prevalence of chronic obstructive pulmonary disease in Copenhagen. Results from the Copenhagen city heart study. Ugeskr Læger. 2007;169(46):3956–3960. - PubMed
    1. Bilde L, Rud Svenning A, Dollerup J, Bække Borgeskov H, Lange P. The cost of treating patients with COPD in Denmark - A population study of COPD patients compared with non-COPD controls. Respir Med. 2007;101:539–546. doi: 10.1016/j.rmed.2006.06.020 - DOI - PubMed