OBJECTIVES: Chronic obstructive pulmonary disease (COPD) affects more than 15 million Americans, significantly impacting health outcomes and imposing considerable economic burdens on both individuals and healthcare systems. This focused literature review (FLR) aimed to assess the direct and indirect costs, healthcare resource usage, and cost drivers among patients with COPD in the United States (US).
METHODS: The search was conducted in Embase, MEDLINE, the Cochrane Library, within respiratory conference summaries and the American College of Chest Physicians and Global Initiative for Chronic Obstructive Lung Disease websites. Documents from 28 July 2012 to 28 July 2022 were reviewed.
RESULTS: Relevant articles were included in this review, after a two-level screening process. The annual direct cost of COPD in the US was determined to be approximately $50 billion, which included costs for hospital stays, doctor consultations, and medications. The highest reported mean cost for a hospitalised exacerbation was $18,120. Considering indirect costs, such as productivity loss and absences from work, total care costs could potentially double this amount. The costs increased as the disease worsened, with severe cases leading to higher hospitalisation rates, increased medication needs, and more work difficulties. COPD related prescription costs ranged from $1,039 for mild COPD to $1,955 for severe stages. COPD patients, particularly those suffering from nocturnal and early morning symptoms, reported higher absenteeism and productivity losses compared to healthy individuals. Furthermore, an incremental 100 cell/μl increase in eosinophil count was associated with a 4.54% increase in COPD costs and a 2.24% increase in overall costs.
CONCLUSIONS: This literature review emphasises the substantial economic burden of COPD in the US. The impact escalates with disease severity, leading to increased direct medical, indirect and treatment costs. Disease severity, exacerbations, productivity loss, and increased eosinophil count are notable contributors to the escalating costs of COPD management.
