The economic burden of chronic obstructive pulmonary disease (COPD) in the USA, Europe, and Asia: results from a systematic review of the literature

ABSTRACT

Background: Lack of information about economic burden of COPD is a major cause of lack of attention to this chronic condition from governments and policymakers.

Objective: To find the economic burden of COPD in Asia, USA and Europe, and to identify the key cost driving factors in management of COPD patients.

Methodology: Relevant studies assessing the cost of COPD from patient perspective or societal perspective were retrieved by thoroughly searching PUBMED, SCIENCE DIRECT, GOOGLE SCHOLAR, SCOPUS, and SAGE Premier Databases.

Results: In the USA annual per patient direct medical cost and hospitalization cost were reported as $10,367 and $6852, respectively. In Asia annual per patient direct medical cost in Iran, Korea and Singapore was reported as $1544, $3077, and $2335, respectively. However, annual per patient hospitalization cost in Iran, Korea, Singapore, India, China, and Turkey was reported as $865, $1371, $1868, $296, $1477 and $1031, respectively. In Europe annual per patient direct medical cost was reported as $11,787, $10,552, $8644, $8203, $7760, $3190, $1889, $2162, and $2254 in Norway, Denmark, Germany, Italy, Sweden, Greece, Spain, Belgium, and Serbia, respectively.

Conclusion: Limiting the disease to early stage and preventing exacerbations may reduce the cost of management of COPD.

KEYWORDS:

• COPD
• direct medical cost
• economic burden
• systematic review

Article highlights

• Inpatient hospitalization and medication are major cost driving factors in the management of COPD.

• Different factors identified to influence the increasing cost of COPD management include severity of disease, frequency of exacerbation, and severity of exacerbation.

• Medication cost is influenced by severity of COPD and frequency of exacerbation. Increase in the frequency of exacerbation from one exacerbation per year to 2 or more exacerbations per year results in 3 folds increase in medication cost of COPD patients.

• Limiting the disease to early stage and preventing exacerbations can reduce the cost of management of COPD.

Author Contributions

AA, AH, SA, SS, IRF and AS made substantial contributions to conception and design of the study, and analysis and interpretation of the data. AA and SA made substantial contributions to analysis and interpretation of the data. All authors drafted the work or revised it critically for important intellectual content. All authors reviewed, critiqued, and approved the final version submitted for publication.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.