Epidemiology and Health Economics of COPD Across Europe

Abstract

COPD is a major cause of morbidity and mortality in Europe. The purpose of this literature review was to critically evaluate published data on COPD prevalence and the cost of COPD interventions in European countries. Selection of literature was based on article retrieval from a systematic literature search using PubMed and EMBASE. Only articles providing data in European countries published between January 1990 and March 2003 were included. European epidemiological (cross-sectional, cohort, case-control) and economic (cost-of-illness-, cost-minimization-, cost-effectiveness-, cost-benefit-, cost-utility-analysis) studies were included. Of 74 retrieved epidemiologic studies, only seven (9%) fulfilled the inclusion criteria. In the selected literature, COPD prevalence ranged from 3% among Finnish women to 57% among Italian men and women, 45 years and older. Of 56 economic studies, 24 satisfied entry criteria. Results from the final cost-of-illness studies indicated that hospital care and medication represented the major portion of costs associated with COPD. In a survey conducted in 1998/99, annual direct expenditures for COPD treatment per patient in Europe ranged from Euro 530 in France to Euro 3238 in Spain. There was a differential increase in COPD prevalence predominantly related to an aging patient population, with a high incidence of exposure to cigarette smoke. Data also showed differences in the economic impact of COPD in Europe based on the proportion of patients with severe COPD, frequency of exacerbations, and number of hospitalizations. Overall, results of this review demonstrated the need for global epidemiologic and economic studies to allow for more uniform guidelines for the prevention and cost-effective treatment of patients with COPD.

Clinical relevance of constant power exercise duration changes in COPD

“…It is doubtful that these patients represent ''outliers'' to the COPD population, rather they represent either an under-or overestimation of the target work rate; moreover, we believe that in both clinical practice and trials, similar adjustments are and will be common and thus our data could be more readily extrapolated if we included such subjects. Fourthly, only ,20% of subjects enrolled were female, although this proportion is consistent with the published gender distribution of COPD in Spain [25,26]. Finally, in the present paper, we studied symptomatically mostly severe (GOLD III) patients and, therefore, inferences upon other populations of COPD subjects have to be made with caution.…”

Usage of inhalation devices in asthma and chronic obstructive pulmonary disease: a Delphi consensus statement

“…What is the potential impact of ID switching and who should initiate the switching procedure? The consideration of these questions is important because incorrect treatment delivery may adversely affect the benefits gained from the therapy [2][3][4], dramatically change the side effects [5] and induce substantial cost increases associated with asthma and COPD [6,7].…”

Reduction in hospitalisation following pulmonary rehabilitation in patients with COPD

“…Hospitalisation due to exacerbation is consistently the greatest cost component of COPD care. [1][2][3] Pulmonary rehabilitation (PR) is an effective management strategy for patients with COPD and has been shown to reduce symptoms and increase exercise capacity and health-related quality of life (HRQoL). 4,5 There is also evidence from randomised controlled trials, 6,7 a systematic review 8 and clinical reports [9][10][11][12][13] that PR reduces health care utilisation in COPD.…”