The direct and indirect costs of managing chronic obstructive pulmonary disease in Greece

Figures & data

Figure 1 Management of COPD patients.

Abbreviation: GP, general practitioner.

Table 1 Laboratory and imaging tests

Tests	Exacerbations		Maintenance phase		Unit cost (€)
	% of patients	Frequency of test per exacerbation	% of patients	Frequency of test per year
Laboratory tests
CBC	81.8	2.2	45.7	1.0	2.9
Biochemical tests*	67.8	2.0	51.5	1.0	21.7
ABG	50.0	2.0	–	–	12.4
CRP	33.3	1.0	–	–	10.0
ESR	33.3	2.0	–	–	1.8
Urine analysis	38.6	1.0	13.8	0.6	1.8
Sputum culture	50.0	1.0	–	–	5.2
Functional/imaging tests
Spirometry	57.1	0.8	85.8	1.1	44.0
Electrocardiography	65.0	1.2	54.2	1.1	4.1
Chest CT	21.7	0.9	22.5	0.8	45.0
Chest radiography	84.1	1.5	53.5	0.9	4.1

Note:

* Includes urea, creatinine, SGOT, SGPT, K, Na, Ca, and LDH assays.

Abbreviations: ABG, arterial blood gases; CBC, complete blood count; CRP, C-reactive protein; CT, computed tomography; ESR, erythrocyte sedimentation rate; LDH, lactate dehydrogenase; SGOT, serum glutamic oxaloacetic transaminase; SGPT, serum glutamic pyruvic transaminase.

Table 2 Annual per-patient costs (€) during exacerbations and maintenance phase

Resource use item	Annual costs associated with the management of exacerbations* (% of total)	Annual costs of the maintenance phase (% of total)
Pharmaceutical treatment	22.6 (1.5)	639.9 (76.6)
Medical treatment	6.8 (0.4)	53.6 (6.4)
Hospitalization	829.9 (54.9)	74.5 (8.9)
ICU admission	453.8 (30.0)	–
Laboratory tests	113.3 (7.5)	12.1 (1.4)
Functional/imaging tests	86.0 (5.7)	54.9 (6.6)
Total costs, €	1,512.4	835.0

Notes:

* Based on the mean number of exacerbations per year (2.17). Numbers have been rounded to the nearest euro, thus percentages might not sum up to 100%.

Abbreviation: ICU, intensive care unit.

Table 3 Total per-patient costs (€)

Cost type	Annual cost, €	% of total cost
Direct medical cost	2,809.7	59.4
Cost of exacerbations	1,512.4	32.0
Costs of maintenance phase	835.0	17.7
Costs of additional resources	462.3	9.8
Direct nonmedical cost	146.1	3.1
Cost of patients’ time	146.1	3.1
Productivity losses	1,774.1	37.5
Cost of work loss days	968.4	20.5
Cost of nonpaid caregivers’ time	805.7	17.0
Total cost	4,729.9	100

Note: The lines in bold are the sum of the rows that follow them, therefore, when total cost is to be estimated, only the bold numbers should be added.