Burden of Chronic Obstructive Pulmonary Disease (COPD) Healthcare Costs in Patients with Moderate-to-Severe Disease

OBJECTIVES: COPD is a major cause of morbidity and mortality with a substantial economic burden. Real-world cost data on moderate-to-severe COPD is needed. In this study we described all-cause and COPD-related healthcare costs among patients with uncontrolled moderate-to-severe COPD during index exacerbation and at three months following the index exacerbation.

METHODS: Retrospective cohort design study using Optum Clinformatics claims data from 01/01/2016 to 12/31/2023. Uncontrolled disease was defined as having ≥2 moderate exacerbation episodes or ≥1 severe exacerbation episode within a 12-month period. Severe exacerbation cohort included patients who experienced ≥1 severe exacerbation episode after the sample entry date. Moderate exacerbation cohort included patients who experienced ≥1 moderate exacerbation episode after the sample entry date. Healthcare costs included medical services and pharmacy costs. All costs were standardized and reported in 2023 US dollars using the Gross Domestic Product Price Index.

RESULTS: COPD cohorts (severe and moderate) included 28,197 and 170,159 patients. Among all severe patients, total mean (SD) all-cause and COPD-related costs during index exacerbation were 23,156.6 (27,995.5) and 21,628.6 (26,728.7) respectively. At the index exacerbation, the mean COPD-related hospitalization, ER and OP costs were 18,764.8 (25,866.0), 1,950.4 (3,830.3) and 615.4 (3,453.8), respectively. Among all moderate patients, all-cause and COPD-related costs were 4,320.2 (11,574.3) and 2,667.2 (8,374.6)), respectively. Mean COPD-related ER and OP visits costs were 1,000.7 (3,378.3) and 1,503.6 (7,466.2), respectively. At 3 months after index exacerbation, mean all-cause and COPD-related costs for severe cohort were 26,680.3 (46,421.2) and 8,255.3 (14,271.2) respectively. Mean COPD-related hospitalization, ER and OP visits costs were 1,686.5 (8,679.2)), 2,083.7 (5,904.5) and 2,015.4 (7,138.5) respectively. Moderate COPD cohort all-cause and COPD-related costs were 18,529.7 (37,806.7) and 4,734.3 (12,293.0) respectively. Mean hospitalization, ER and OP visits COPD costs were 427.8 (5,417.2)), 1,012.2 (4,294.8) and 1,957.3 (9,073.0), respectively.

CONCLUSIONS: The economic burden of severe COPD is higher compared to moderate COPD.