Chest
Volume 147, Issue 1, January 2015, Pages 31-45
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Original Research: COPD
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

https://doi.org/10.1378/chest.14-0972Get rights and content

BACKGROUND

COPD remains a leading cause of morbidity and mortality. The objectives of this study were to estimate (1) national US COPD-attributable annual medical costs by payer (direct) and absenteeism (indirect) in 2010 and projected medical costs through 2020 and (2) state-specific COPD-attributable medical and absenteeism costs in 2010.

METHODS

We used the 2006-2010 Medical Expenditure Panel Survey, the 2004 National Nursing Home Survey, and 2010 Centers for Medicare and Medicaid Services data to generate cost estimates and 2010 census data to project medical costs through 2020.

RESULTS

In 2010, total national medical costs attributable to COPD and its sequelae were estimated at $32.1 billion, and total absenteeism costs were $3.9 billion, for a total burden of COPD-attributable costs of $36 billion. An estimated 16.4 million days of work were lost because of COPD. Of the medical costs, 18% was paid for by private insurance, 51% by Medicare, and 25% by Medicaid. National medical costs are projected to increase from $32.1 billion in 2010 to $49.0 billion in 2020. Total state-specific costs in 2010 ranged from $49.1 million in Wyoming to $2.8 billion in California: medical costs ranged from $42.5 million in Alaska to $2.5 billion in Florida and absenteeism costs ranged from $8.4 million in Wyoming to $434.0 million in California.

CONCLUSIONS

Costs attributable to COPD and its sequelae are substantial and are projected to increase through 2020. Evidence-based interventions that prevent tobacco use and reduce the clinical complications of COPD may result in potential decreased COPD-attributable costs.

Section snippets

Materials and Methods

Detailed methods are described in the supplement (e-Appendix 1). The main data source for generating baseline and projected costs was the 2006 to 2010 MEPS.11 Supplemental data sources included the National Nursing Home Survey, the US Census Bureau, and the Centers for Medicare and Medicaid Services. Estimates are limited to adults aged ≥ 18 years. Because this study used public-use data sets, no subject approval was needed.

Results

The data from MEPS show that participants with COPD were older, more likely to be women, and more likely to be non-Hispanic White (Table 1). Furthermore, almost 78% of participants with COPD had one or more comorbidities, compared with about 50% of participants without COPD. In descending order, the most common comorbidities among participants with COPD were hypertension, arthritis, dyslipidemia, asthma, and injuries.

Discussion

Using the most comprehensive approach to date, we estimated that costs attributable to COPD and its sequelae were about $32.1 billion in 2010. To our knowledge, our analyses provide the first estimates of state-specific costs for state officials, public health practitioners, and other stakeholders charged with reducing the burden of COPD.

The previously reported national estimates generated by the National Heart, Lung, and Blood Institute consist of direct costs, morbidity-associated costs, and

Conclusions

Our analyses provide, we believe for the first time, state-specific costs for COPD, which equip state public health practitioners with estimates of the economic burden of COPD within their borders and illustrate the potential medical and absenteeism costs savings to states through implementing state-level programs that are designed to prevent the onset of COPD (eg, tobacco prevention and cessation). The range of evidence-based strategies to prevent COPD and decrease its effects provides

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    FUNDING/SUPPORT: This work was supported by the Centers for Disease Control and Prevention [Contract No. 200-2008-27958-0002 task order 00006].

    AMERICAN COLLEGE OF CHEST PHYSICIANS. Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.

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