Exploring the Economic Burden Associated With Chronic Obstructive Pulmonary Disease (COPD) Due to Alpha1 Antitrypsin Deficiency (AATD): A Systematic Literature Review (SLR)
Author(s)
Olivia Crossley, BSc, MSc1, Charles Knott, BSc, MSc2, Apoorva Bodke, BSc, MSc3, Michael Tang, BSc4.
1Associate, Nexus Values, Southend On Sea, United Kingdom, 2Nexus Values, Blackburn, United Kingdom, 3Nexus Values, Nottingham, United Kingdom, 4Nexus Values, Hornchurch, United Kingdom.
1Associate, Nexus Values, Southend On Sea, United Kingdom, 2Nexus Values, Blackburn, United Kingdom, 3Nexus Values, Nottingham, United Kingdom, 4Nexus Values, Hornchurch, United Kingdom.
OBJECTIVES: AATD is a rare genetic condition with increased risk of lung diseases such as COPD. Patients with AATD-related COPD (AATD-COPD) are prone to lung exacerbations which necessitate additional treatment. Compared with non-AATD-associated COPD (COPD only), AATD-COPD generally has a younger onset and faster disease progression than COPD only. Understanding the economic implications of AATD-COPD is important for clinical decision making.
METHODS: An SLR was conducted on February 7, 2025 in EMBASE to identify the economic burden associated with AATD. Eligible studies were published from 2008 (2020 for conference proceedings) and presented data on HCRU or direct/indirect costs. Citations were assessed by two reviewers, with discrepancies reconciled by a third. For this sub-analysis, data associated with AATD-COPD were single-extracted.
RESULTS: 259 citations were assessed, with 43 studies included; 6 reported data on the economic burden of AATD-COPD, with 1 publication identified via grey literature searching. Mean annual healthcare costs for AATD-COPD ranged from $142,406-$167,935 in the US and €5,096-€78,930 in Europe, varying greatly according to treatment. One study reported that AATD-COPD had 2-fold greater total healthcare costs compared with COPD only. Ambulatory visits were more frequent with AATD-COPD (25-58 annually) compared to COPD only (26 annually). Proportion of patients with AATD-COPD requiring ≥1 annual inpatient stay was 24%-32%, with greater inpatient burden in COPD only (27%-39%). Indirect cost data for AATD-COPD were limited, 1 study showed costs due to premature retirement as a substantial cost driver with AATD-COPD (€13,129 annually).
CONCLUSIONS: While AATD-COPD and COPD present with common symptoms including breathless and chronic cough, there is a higher economic burden associated with AATD-COPD. Outpatient visits were a key economic burden driver in AATD-COPD, reporting more frequent visits and higher total costs than COPD only. This highlights the additional complications in AATD which require regular monitoring and management with a need for improved future treatments.
METHODS: An SLR was conducted on February 7, 2025 in EMBASE to identify the economic burden associated with AATD. Eligible studies were published from 2008 (2020 for conference proceedings) and presented data on HCRU or direct/indirect costs. Citations were assessed by two reviewers, with discrepancies reconciled by a third. For this sub-analysis, data associated with AATD-COPD were single-extracted.
RESULTS: 259 citations were assessed, with 43 studies included; 6 reported data on the economic burden of AATD-COPD, with 1 publication identified via grey literature searching. Mean annual healthcare costs for AATD-COPD ranged from $142,406-$167,935 in the US and €5,096-€78,930 in Europe, varying greatly according to treatment. One study reported that AATD-COPD had 2-fold greater total healthcare costs compared with COPD only. Ambulatory visits were more frequent with AATD-COPD (25-58 annually) compared to COPD only (26 annually). Proportion of patients with AATD-COPD requiring ≥1 annual inpatient stay was 24%-32%, with greater inpatient burden in COPD only (27%-39%). Indirect cost data for AATD-COPD were limited, 1 study showed costs due to premature retirement as a substantial cost driver with AATD-COPD (€13,129 annually).
CONCLUSIONS: While AATD-COPD and COPD present with common symptoms including breathless and chronic cough, there is a higher economic burden associated with AATD-COPD. Outpatient visits were a key economic burden driver in AATD-COPD, reporting more frequent visits and higher total costs than COPD only. This highlights the additional complications in AATD which require regular monitoring and management with a need for improved future treatments.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE458
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Work & Home Productivity - Indirect Costs
Disease
Genetic, Regenerative & Curative Therapies, No Additional Disease & Conditions/Specialized Treatment Areas, Rare & Orphan Diseases, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)