Study Examines Projected Health and Economic Burden of COPD in the U.S.
Research led by Dr. Zafar Zafari will help inform future studies and guide policy decisions to reduce health care and economic costs associated with COPD in the U.S.
By Malissa Carroll
December 18, 2020
A new study led by Zafar Zafari, MSc, PhD, assistant professor in the Department of Pharmaceutical Health Services Research (PHSR) at the University of Maryland School of Pharmacy, offers projected estimates of the health and economic burden associated with chronic obstructive pulmonary disease (COPD) in the U.S. over the next 20 years. Published in CHEST, the study titled “Projecting Long-Term Health and Economic Burden of Chronic Obstructive Pulmonary Disease in the United States,” provides critical data that policymakers can use to inform key decisions that may help mitigate these costs over time.
“COPD is a life-threatening illness that takes a significant, detrimental toll on American society,” says Zafari. “Having estimates for the projected burden of this disease on society is an integral step for planning future care. When such estimates capture both the economic and health consequences of the disease, they can help inform state and federal budget allocations for cost-effective investments in research as well as comprehensive policy actions to reduce that projected burden in the coming years.”
COPD describes a group of diseases that cause airflow blockage and other breathing-related problems, such as emphysema and chronic bronchitis. There is no cure for COPD, and the disease remains a leading cause of death in the U.S. Approximately 16 million Americans are currently living with a COPD diagnosis, and that number is projected to grow over time. Estimating the projected burden of this disease on the population gives policymakers and other stakeholders a better understanding of the future health care and economic costs associated with caring for patients with that illness.
Zafari and his team used publicly available data to develop a dynamic open-cohort Markov model to project the 20-year health and economic burden of COPD in the U.S. from 2019 to 2038. The team modeled population growth across different subgroups — including groups characterized by age, sex, and smoking habits — calibrating COPD prevalence rates for the various subgroups and modeling the distributions of severity grades based on smoking status.
“Our modeling practice provides a flexible policy platform for evaluating different ‘what if’ scenarios in tackling the burden of COPD in the U.S.,” says Zafari. “Using this method, our team was able to project the direct costs, indirect costs, losses of quality-adjusted life years (QALYs), and number of exacerbations and deaths associated with COPD in the U.S. over the next 20 years.”
Direct medical costs associated with COPD were projected to be $800.90 billion, with indirect absenteeism costs estimated to reach $101.30 billion. The projected loss of QALYs – a common policy metric for measuring health across different jurisdictions that captures both longevity and health-related quality of life of patients – was 45.38 million, and the estimated number of exacerbations and deaths associated with COPD were 315.08 million and 9.42 million, respectively.
Since smoking is a leading cause in the development of COPD, it is not surprising to learn that Zafari and his team found that the proportion of COPD burden attributed to continued smoking was 34 percent in direct medical costs, 35 percent in indirect costs, and 37 percent in losses of QALYs over 20 years.
Zafari and his team also compared their projected estimates of the health and economic burden associated with COPD to similar estimates for diabetes. Their analysis showed that the projected direct and indirect costs associated with diabetes over the next 20 years will be approximately $3941 billion and $53 billion, respectively.
“One in seven U.S. health care dollars is spent on diabetes, while only one in 35 health care dollars is spent on COPD,” explains Zafari. “Despite the fact that the projected burden of COPD is only one-fifth of that of diabetes, the annual spending of the National Institutes of Health on research for COPD was almost one-tenth of its spending on diabetes in 2018, which is disproportionately lower than the relative societal burden of the two conditions.”
He adds, “Our study provides the evidence needed to support objective decision-making for federal budget appropriations for research and development in COPD.”
The study was funded by the American Lung Association and the Institute for Clinical and Translational Research at the University of Maryland, Baltimore (UMB).