Projecting Long-Term Health and Economic Burden of COPD in the United States
MetadataShow full item record
AbstractBackground: In the United States, COPD is a leading cause of mortality, with a substantial societal health and economic burden. With anticipated population growth, it is important for various stakeholders to have an estimate for the projected burden of disease. Research Question: The goal of this study was to model the 20-year health and economic burden of COPD, from 2019 to 2038, in the United States. Study Design and Methods: Using country-specific data from published literature and publicly available datasets, a dynamic open cohort Markov model was developed in a probabilistic Monte Carlo simulation. Population growth was modeled across different subgroups of age, sex, and smoking. The COPD prevalence rates were calibrated for different subgroups, and distributions of severity grades were modeled based on smoking status. Direct costs, indirect absenteeism costs, losses of quality-adjusted life years (QALYs), and number of exacerbations and deaths associated with COPD were projected. Results: The 20-year discounted direct medical costs attributable to COPD were estimated to be $800.90 billion (95% credible interval [CrI], 565.29 billion-1,081.29 billion), with an expected $337.13 billion in male subjects and $463.77 billion in female subjects. The 20-year discounted indirect absenteeism costs were projected to be $101.30 billion (70.82 billion-137.41 billion). The 20-year losses of QALYs, number of exacerbations, and number of deaths associated with COPD were 45.38 million (8.63 million-112.07 million), 315.08 million (228.59 million-425.33 million), and 9.42 million (8.93 million-9.93 million), respectively. The proportion of disease burden attributable to continued smoking was 34% in direct medical costs, 35% in indirect absenteeism costs, and 37% in losses of QALYs over 20 years. Interpretation: This study projects the substantial burden of COPD that the American society is expected to incur with current patterns for treatments and smoking rates. Mitigating such burden requires targeted budget appropriations and cost-effective interventions.
Rights/TermsCopyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
Monte Carlo simulation
economic burden projection
health burden projection
stochastic dynamic Markov model
Identifier to cite or link to this itemhttp://hdl.handle.net/10713/15113
- The health and economic burden of smoking in 12 Latin American countries and the potential effect of increasing tobacco taxes: an economic modelling study.
- Authors: Pichon-Riviere A, Alcaraz A, Palacios A, Rodríguez B, Reynales-Shigematsu LM, Pinto M, Castillo-Riquelme M, Peña Torres E, Osorio DI, Huayanay L, Loza Munarriz C, de Miera-Juárez BS, Gallegos-Rivero V, De La Puente C, Del Pilar Navia-Bueno M, Caporale J, Roberti J, Virgilio SA, Augustovski F, Bardach A
- Issue date: 2020 Oct
- The Economic Impact of Smoking and of Reducing Smoking Prevalence: Review of Evidence.
- Authors: Ekpu VU, Brown AK
- Issue date: 2015
- Total and state-specific medical and absenteeism costs of COPD among adults aged ≥ 18 years in the United States for 2010 and projections through 2020.
- Authors: Ford ES, Murphy LB, Khavjou O, Giles WH, Holt JB, Croft JB
- Issue date: 2015 Jan
- Future impact of various interventions on the burden of COPD in Canada: a dynamic population model.
- Authors: Najafzadeh M, Marra CA, Lynd LD, Sadatsafavi M, FitzGerald JM, McManus B, Sin D
- Issue date: 2012
- The effectiveness of school-based family asthma educational programs on the quality of life and number of asthma exacerbations of children aged five to 18 years diagnosed with asthma: a systematic review protocol.
- Authors: Walter H, Sadeque-Iqbal F, Ulysse R, Castillo D, Fitzpatrick A, Singleton J
- Issue date: 2015 Oct