Abstract
Introduction: Asthma and COPD are known to have significant health and economic consequences. Little is known about the costs of the latter in the UK. In this study we report the results of a comparison of the direct medical costs associated with COPD and asthma, where diagnoses are based on a robust prevalence study of a random sample of the Northern Ireland population.
Methods: A two-stage survey was used to identify individuals with COPD and asthma. The diagnoses of asthma and COPD were based on patient history and lung function. Patients completed a detailed questionnaire covering healthcare utilization over the past 12 months, socioeconomic characteristics, impact of the disease on quality of life, and activities of daily living.
Results: Forty-nine patients were diagnosed with COPD and 57 with asthma. Three asthma patients were excluded from the main analysis because they were thought to have atypical inpatient stays or other resource use. The mean direct healthcare cost for each COPD patient was estimated at £171.69 ($US309; year 2000 value) per annum, significantly less than the average cost of asthma among the 54 analyzed of £544.54 ($US980) [p < 0.05]. A correlation analysis revealed that among COPD patients, disease severity, defined by lung function, was a significant predictor of costs.
Conclusion: Community-based costs for asthma are greater than those for COPD; this may relate in part to a relative under-diagnosis of COPD (73.5% COPD vs 15.8% asthma). As anticipated, the cost of COPD increases as FEV1 decreases. Further analysis will enable modeling of the cost consequences of both increased diagnosis and better management of COPD.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
National Institute for Health and Clinical Excellence [online]. Available from URL: http://www.nice.org.uk [Accessed 2006 Mar 23]
American Thoracic Society. Standard for the diagnosis and care of patients with chronic obstructive pulmonary disease. Am J Resp Crit Care Med 1995; 152: S77–120
Fletcher D, Peto R, Tinker C, et al. The natural history of chronic bronchitis and emphysema: an eight year study of early chronic obstructive lung disease in working men in London. Oxford: Oxford University Press, 1976
Bergner M, Hudson LD, Conrad DA, et al. The cost and efficacy of home care for patients with chronic lung disease. Med Care 1988; 26: 566–79
Sherrill DL, Lebowitz MD, Burrows B. Epidemiology of chronic obstructive pulmonary disease. Clin Chest Med 1990; 11: 375–87
National Center for Health Statistics: Health E Stats [online]. Available from URL: www.cdc.gov/nchs/products/pubs/pubd/hestats/asthma/asthma.htm [Accessed 2002 Aug 13]
Global initiative for asthma (GINA) [online]. Available from URL: http://ginasthma.com [Accessed 2006 Mar 23]
Barbee RA, Murphy S. The natural history of asthma. J Allergy Clin Immunol 1998; 102: S65–72
Benson V, Marano MA. Current estimates from the National Health Interview Survey, 1993. Washington, DC: National Centre for Health Statistics, Vital and Health Statistics 10 (190), 1994. DHHS Publication No. (PHS) 95-1518
Singh GK, Matthews TJ, Clark SC, et al. Annual summary of births, marriages, divorces and deaths: United States, 1994; monthly vital statistics report (Vol. 43, No. 13). Hyattsville (MD): National Centre for Health Statistics, 1994
Ward MM, Javitz HS, Smith WM, et al. Direct medical cost of chronic obstructive pulmonary disease in the USA. Respir Med 2000; 94: 1123–9
Hilleman DE, Dewan N, Malesker M, et al. Pharmacoeconomic evaluation of COPD. Chest 2000; 118(5): 1278–85
American Lung Association. Asthma in adults fact sheet [online]. Available from URL: http://www.lungusa.org [Accessed 2005 Apr 18]
Smith DH, Malone DC, Lawson KA, et al. A national estimate of the economic costs of asthma. Am J Respir Crit Care Med 1997; 156(3): 787–93
Weiss KB, Gergen PJ, Hodgson TA. An economic evaluation of asthma in the United States. N Engl J Med 1992; 326: 862–6
Szucs TD, Anderhub H, Rutishauser M. The economic burden of asthma: direct and indirect costs in Switzerland. Eur Respir J 1999; 13(2): 281–6
Krahn MD, Berka C, Langlois P, et al. Direct and indirect costs of asthma in Canada, 1990. CMAJ 1996; 154(6): 821–31
Mellis CM, Peat JK, Bauman AE, et al. The cost of asthma in New South Wales. Med J Aust 1991; 155(8): 522–8
Kiivet RA, Kaur I, Lang A, et al. Costs of asthma treatment in Estonia. Eur J Public Health 2001; 11(1): 89–92
Rutten van-Molken MP, Feenstra TL. The burden of asthma and chronic obstructive pulmonary disease: data from The Netherlands. Pharmacoeconomics 2001; 19 Suppl. 2: 1–6
Pelletier-Fleury N, Lanoe JL, Fleury B, et al. The cost of treating COPD patients with long-term oxygen therapy in a French population. Chest 1996; 110(2): 411–6
Guest JF. The annual cost of chronic obstructive pulmonary disease to the UK’s National Health Service. Dis Manage Health Outcomes 1999; 5: 93–100
Britton M. The burden of COPD in the UK: results from the Confronting COPD survey. Respir Med 2003; 97 Suppl. C: S71–9
Murtagh E, Heaney LG, Gingles J, et al. The prevalence of obstructive lung disease in a general population sample: the NICECOPD study. Eur J Epidemiol 2005 May; 20(5): 443–53
Fletcher CM. Standardised questionnaire on respiratory symptoms: a statement prepared and approved by the MRC Committee on the Aetiology of Chronic Bronchitis (MRC breathlessness score). BMJ 1960; 2: 1665
Quanjer PH, Lebowitz MD, Gregg I, et al. Peak expiratory flow: conclusions and recommendations of a Working Party of the European Respiratory Society. Eur Respir J Suppl 1997; 24: 2S–8S
EuroQol quality of life assessment (EQ5D). EuroQol Group, PO Box 4443, 3006 AK Rotterdam, The Netherlands
Netten A, Dennet J. Unit costs of health and social care 2000. Canterbury: PSSRU University of Kent at Canterbury (UK), 2000
British National Formulary. London: British Medical Association, 2000
Ungar WJ, Coyte PC, Chapman KR, et al. The patient level cost of asthma in adults in south central Ontario: Pharmacy Medication Monitoring Program Advisory Board. Can Respir J 1998; 5(6): 463–71
Acknowledgments
The authors would like to acknowledge GlaxoSmithKline and the Eastern Health and Social Services Board for providing support for the study. The authors have no conflicts of interest that are directly relevant to the content of this article.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Murtagh, E., O’Neill, C., McAllister, D. et al. A Cross-Sectional Comparison of Direct Medical Care Costs among COPD and Asthma Patients Living in the Community in Northern Ireland. Treat Respir Med 5, 495–501 (2006). https://doi.org/10.2165/00151829-200605060-00012
Published:
Issue Date:
DOI: https://doi.org/10.2165/00151829-200605060-00012