OBJECTIVES

Chronic Obstructive Pulmonary Disease (COPD) induces a considerable economic burden – both on an individual- and at a societal level. The aims of this study were to assess the direct and indirect costs associated with COPD, and how costs vary across disease severities.

METHODS

This was an observational, population-based cohort study utilizing Danish health registries. Individuals in the COPD Registry, ≥40 years of age, with an in- and/or outpatient diagnosis of COPD (ICD-10 J44) in 2008-2016 were included; and matched 1:4 to a population-based comparison cohort of 316,984 individuals by sex, birth year, co-habitation status, and municipality. Patients were grouped according to GOLD groups A-D by disease severity based on moderate- (short-term oral corticosteroid use) and severe (emergency visit or hospitalization) exacerbations and symptom scores. Index was date of symptom score measurement, and patients were followed for costs for 12 months post-index in 2008-2017. All costs were captured through DRG codes collected in the registries for reimbursement purposes.

RESULTS

In all, 82 633 COPD patients were included. Total annual health care costs, including direct costs, costs for elderly care, and costs for retirement home, were higher for the patients with COPD (€31,441) compared with the reference population (€10,491), p<0.001. In GOLD group A-D, the total direct costs were A: €8,687, B: €12,884, C: €12,050, and D: €18,977, respectively. The average costs per moderate and severe exacerbation were €876 and €6933, respectively, during 28 days of follow-up.

CONCLUSIONS

This real-world study provided insight into the economic consequences of COPD. Total direct costs were three-fold higher among the patients with COPD compared with the reference population. A major driver of direct costs was severe exacerbations. The costs were lowest and highest in GOLD group A and D respectively, which supports previous findings reporting higher costs with increasing severity of disease.