Jeno P. Marton

Assessment of the Economic Burden of COPD in the U.S.: A Review and Synthesis of the Literature

The costs of chronic obstructive pulmonary disease (COPD) pose a major economic burden to the United States. Studies evaluating COPD costs have generated widely variable estimates; we summarized and critically compared recent estimates of the annual national and per-patient costs of COPD in the U.S. Thirteen articles reporting comprehensive estimates of the direct costs of COPD (costs related to the provision of medical goods and services) were identified from searches of relevant primary literature published since 1995. Few papers reported indirect costs of COPD (lost work and productivity). The National Heart, Lung, and Blood Institute (NHLBI) provides the single current estimate of the total (direct plus indirect) annual cost of COPD to the U.S.,

The economic burden of chronic obstructive pulmonary disease (COPD) in a U.S. Medicare population

38.8 billion in 2005 dollars. More than half of this cost (

Direct costs of COPD in the U.S : An analysis of medical expenditure panel survey (MEPS) data

21.8 billion) was direct, aligning with the

Undertreatment of COPD: a retrospective analysis of US managed care and Medicare patients

20–26 billion range reported by two other recent analyses of large national datasets. For per-patient direct costs (in

A retrospective analysis of disability and its related costs among employees with chronic obstructive pulmonary disease.

US 2005), studies using recent data yield attributable cost estimates (costs deemed to be related to COPD) in the range of

Lung function and respiratory symptoms in a 1-year randomized smoking cessation trial of varenicline in COPD patients

2,700–

A New Method for Examining the Cost Savings of Reducing COPD Exacerbations

5,900 annually, and excess cost estimates (total costs incurred by COPD patients minus total costs incurred by non-COPD patients) in the range of

Smoking, smoking cessation and smoking relapse patterns: a web-based survey of current and former smokers in the US

6,100–

Inpatient treatment patterns, outcomes, and costs of skin and skin structure infections because of Staphylococcus aureus.

6,600 annually. Studies of both national and per-patient costs that use data approximately 8–10 years old or older have produced estimates that tend to deviate from these ranges. Cost-of-illness studies using recent data underscore the substantial current cost burden of COPD in the U.S.

Costs of skin and skin structure infections due to Staphylococcus aureus : an analysis of managed-care claims

RATIONALE Although the economic burden of COPD has gained attention in recent years, data on the costs of COPD among U.S. Medicare beneficiaries are lacking. METHODS This study used administrative claims and eligibility records from a large U.S. multi-state Medicare managed care database. Study patients were 65+ years of age with paid claims during 2004. The COPD cohort comprised patients with 1+ inpatient/ER claims or 2+ outpatient claims (>30 days apart) for COPD (ICD-9-CM codes 491.xx, 492.x, 496). The comparison cohort included patients without COPD matched 3:1 to the COPD cohort on age, sex, enrollment months, and Medicare plan. Excess costs of COPD were estimated as the difference in overall health plan payments between the two cohorts during 2004. Attributable costs were calculated using medical claims with listed diagnoses of COPD or other respiratory-related conditions and pharmacy claims for respiratory medications. RESULTS A total of 8370 patients were included in the COPD cohort and were matched to 25,110 comparison cohort patients. For both groups, mean (SD) age was 78 (8) years, 54% were female, and duration of eligibility was 11 (2) months. COPD patients were more likely to utilize healthcare services and had excess total healthcare costs about