OBJECTIVES

This study aims to provide a nationally representative estimate of the economic burden of chronic obstructive pulmonary disease (COPD) by examining direct medical costs, out-of-pocket costs, frequently used and expensive prescription drugs, and mortality costs among individuals aged >=45 years in the United States (US).

METHODS

Data from the Medical Expenditure Panel Survey (2017-2018) and WONDER online tool were used to estimate the direct medical costs and mortality costs associated with COPD. COPD-related costs were determined for the various service categories by: 1) using the sum of disease-specific medical expenditures (attribution) approach; and 2) calculating the incremental expenditures using a two-part regression-based statistical approach. Mortality costs were determined using the value of statistical life approach.

RESULTS

The number of patient-years with COPD over two years in a total sample of 23,590 patient-years was 1,073. Among COPD patients, using the attributable costs approach, the mean annual COPD-related costs per patient were 2018 US $3,385.57 (Standard Error (SE): 276.33). Using the incremental expenditures approach, the mean annual COPD-related costs per patient were $3954.49 (SE: 578.47). The mean out-of-pocket costs for COPD-related expenses among COPD patients was $255.34 (SE: 26.10) per patient-year which contributed to 11.88% of the total prescription drug costs. Further, the 5 most commonly prescribed COPD-related prescription drugs were Spiriva, Symbicort, Ventolin HFA, Proair HFA, and Albuterol. Likewise, the most burdensome COPD-related prescription drugs among COPD patients were in a descending order Spiriva, Symbicort, Advair diskus, Bronchodilator combinations, and Breo ellipta. Mortality related costs associated with a COPD patient were estimated at $1,543.86 billion.

CONCLUSIONS

This study provides updated estimates of the significant economic burden of COPD among a nationally representative sample of individuals across multiple payers in the US. Our results also quantify the significant mortality related costs of COPD as well as economic burden of comorbidly in COPD in the US.