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Cost of Medical Care in Early Stages of COPD

People who suffer from a moderate form of COPD cause around 990 euros higher medical costs due to illness per year than comparable individuals who do not have the disease. For the treatment of this
disease stage alone, this means annual costs of about two billion euros for the German healthcare system. Therefore preventive measures are needed to stop the development and progression of COPD.

Scientists of the Institute of Health Economics and Health Care Management at Helmholtz Zentrum München have investigated the associ­ation between early stages of COPD and the utilization of medical care. The researchers based their investigation on the KORA study comprising more than 2000 participants between 40 and 90 years of age. The aim of the study was to determine whether already in the early stages of COPD there are excess costs for medical care.

COPD is commonly known as smoker’s cough; the official name is chronic obstructive pulmonary disease. The disease is incurable; it is only possible to slow its progression. An estimated 13 percent of adults in Germany over 40 years of age suffer from this disease, whereby in the early stages it usually remains undiagnosed.

The researchers calculated the costs per year incurred by visits to the doctor, hospital stays and medications for these individuals. By means of a pulmonary function test they identified test subjects with reduced lung function and classified them into mild (Stage I) or moderate (Stage II) COPD. In computer-
assisted interviews using detailed question­naires, participants were asked about their visits to the doctor, hospital stays and medications. From this data, their costs for medical care were derived. Then the researchers compared the calculated costs between participants with and without COPD taking age, sex and level of education into account. The results show that people with early stage (I) COPD do not cause substantially higher costs for medical treatment than participants without the disease.

However, as soon as the moderate stage is reached, costs increase and are on average 990 euros higher per year for people with COPD compared to people with normal lung function. In view of the high incidence of COPD, this means that alone for the treatment of this stage, annual costs of about two billion euros are incurred for the German health care system. The total costs of COPD are many times higher, especially when patients in stages III and IV are included in the cost calculation. In order to quantify these costs as well, the research group collaborates within the Competence Network COPD, where informa­tion from 2700 patients across Germany is being collected and analyzed.

So far, from these results, the researchers conclude that suitable preventive measures are needed for COPD not only from a medical perspective but also from an economic perspective to keep the disease from progressing to a more advanced stage. First and foremost, this means that smokers who already suffer from mild COPD should be motivated to stop smoking, since smoking cessation is one of the most effective interventions to slow the worsening of the disease.

COPD stands forchronic obstructive pulmonary disease. It is caused by a chronic inflammatory pulmonary disorder that leads to the narrowing of the small airways. It occurs primarily in smokers and is often accompanied by coughing, excessive mucus production and breathlessness



Comparison of the frequency of outpatient visits, hospital stays and use of medication between healthy individuals and subjects with COPD in the mild stage (I) or moderate stage (II). The resulting costs were estimated, taking into account age, sex and level of education. Source: HMGU