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. 2024 May 13:19:1033-1046.
doi: 10.2147/COPD.S446696. eCollection 2024.

Disease Burden and Health-Related Quality of Life (HRQoL) of Chronic Obstructive Pulmonary Disease (COPD) in the US - Evidence from the Medical Expenditure Panel Survey (MEPS) from 2016-2019

Melissa H Roberts  1 , David M Mannino  2   3 , Douglas W Mapel  4 , Orsolya Lunacsek  5 , Shahla Amin  5 , Eileen Farrelly  5 , Norbert Feigler  6 , Michael F Pollack  6
Affiliations

Disease Burden and Health-Related Quality of Life (HRQoL) of Chronic Obstructive Pulmonary Disease (COPD) in the US - Evidence from the Medical Expenditure Panel Survey (MEPS) from 2016-2019

Melissa H Roberts et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Purpose: Chronic obstructive pulmonary disease (COPD) is a progressive disease associated with reduced life expectancy, increased morbidity, mortality, and cost. This study characterized the US COPD burden, including socioeconomic and health-related quality of life (HRQoL) outcomes.

Study design and methods: In this retrospective, cross-sectional study using nationally representative estimates from Medical Expenditures Survey (MEPS) data (2016-2019), adults (≥18 years) living with and without COPD were identified. Adults living without COPD (control cohort) and with COPD were matched 5:1 on age, sex, geographic region, and entry year. Demographics, clinical characteristics, socioeconomic, and generic HRQoL measures were examined to include a race-stratified analysis of people living with COPD.

Results: A total of 4,135 people living with COPD were identified; the matched dataset represented a weighted non-institutionalized population of 11.3 million with and 54.2 million people without COPD. Among people living with COPD, 66.3% had ≥1 COPD-related condition; 62.7% had ≥1 cardiovascular condition, compared to 33.5% and 50.5% without COPD. More people living with COPD were unemployed (56.2% vs 45.3%), unable to work due to illness/disability (30.1% vs 12.1%), had problems paying bills (16.1% vs 8.8%), reported poorer perceived health (fair/poor: 36.2% vs 14.4%), missed more working days due to illness/injury per year (median, 2.5 days vs 0.0 days), and had limitations in physical functioning (40.1% vs 19.4%) (all P<0.0001). In race-stratified analyses for people living with COPD, people self-reporting as Black had higher prevalence of cardiovascular-risk conditions, poorer socioeconomic and HRQoL outcomes, and higher healthcare expenses than White or Other races.

Conclusion: Adults living with COPD had higher clinical disease burden, lower socioeconomic status, and reduced HRQoL than those without, with greater disparities among Black people living with COPD compared to White and other races. Understanding the characteristics of patients helps address care disparities and access challenges.

Keywords: COPD; burden of illness; healthcare cost; race/ethnicity.

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Conflict of interest statement

MFP and NF are full-time employees and stockholders of AstraZeneca. MHR, DMM, and DWM are paid consultants of AstraZeneca. MHR reports consulting and/or research funding from AstraZeneca, GSK plc., and Sunovion Pharmaceuticals. DMM is a paid consultant to AstraZeneca, GSK plc, Regeneron, Genentech, Up-to-Date, and Schlesinger Law Firm. He is also an expert witness on behalf of people suing the tobacco and vaping industries. DWM reports research funding from AstraZeneca, GSK plc., and Sunovion Pharmaceuticals and is a paid consultant for Novartis and Theravance. EF, OL, and SA are or were employees of Cencora at the time research was conducted. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Key cardiovascular concurrent conditionsa by COPD status among adults aged ≥18 years.
Figure 2
Figure 2
Socioeconomic and HRQoL outcomes in people living with COPD and without COPD, 2019 (MEPS).
Figure 3
Figure 3
Socioeconomic and HRQoL outcomes in people living with COPD stratified by race, 2019 (MEPS).
Figure 4
Figure 4
HCRU outcomes in people living with COPD and without COPD, 2019 (MEPS).
Figure 5
Figure 5
HCRU outcomes in people living with COPD stratified by race, 2019 (MEPS).
See this image and copyright information in PMC

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