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Original Research: Obstructive Lung Diseases |

Ten-Year Trends in Direct Costs of COPDTen-Year Trends in Direct Costs of COPD: A Population-Based Study

Amir Khakban, MSc; Don D. Sin, MD, MPH; J. Mark FitzGerald, MD; Raymond Ng, PhD; Zafar Zafari, MSc; Bruce McManus, MD, PhD; Zsuzsanna Hollander, PhD; Carlo A. Marra, PharmD, PhD; Mohsen Sadatsafavi, MD, PhD
Author and Funding Information

From the Collaboration for Outcomes Research and Evaluation (Mr Khakban), Faculty of Pharmaceutical Sciences, Institute for Heart + Lung Health (Drs Sin, FitzGerald, and Sadatsafavi), Department of Medicine, Respiratory Division, and the Centre for Clinical Epidemiology and Evaluation (Mr Zafari and Dr Sadatsafavi), the University of British Columbia, Vancouver, BC; Institute for Heart + Lung Health (Drs Ng, McManus, and Hollander), Center of Excellence for Prevention of Organ Failure (PROOF Centre), Vancouver, BC; and School of Pharmacy (Dr Marra), Memorial University of Newfoundland, St. John’s, NF, Canada.

CORRESPONDENCE TO: Mohsen Sadatsafavi, MD, PhD, Centre for Clinical Epidemiology and Evaluation, 7th Floor, 828 W 10th Ave, Research Pavilion, Vancouver, BC, V5Z 1M9, Canada; e-mail: msafavi@mail.ubc.ca


FUNDING/SUPPORT: This study was supported by the Institute for Heart + Lung Health, the University of British Columbia. Mr Khakban receives salary support from Genome Canada: Genome British Columbia, Providence, St. Paul’s Hospital Foundation, and PROOF Centre. Dr Sadatsafavi receives salary support from the National Sanitarium Association and is also supported by the Early Research Leaders Initiative from the Canadian Respiratory Research Network. Dr Sin is a Tier 1 Canada Research Chair in COPD.

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


Chest. 2015;148(3):640-646. doi:10.1378/chest.15-0721
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BACKGROUND:  Up-to-date estimates of burden of diseases are required for evidence-based decision-making. The objectives of this study were to determine the excess costs of COPD and its trend from 2001 to 2010 in British Columbia, Canada.

METHODS:  We used British Columbia’s administrative health data to construct a cohort of patients with COPD and a matched comparison cohort of subjects without COPD. We followed each patient from the time of first COPD-related health-care event (or equivalent time for the comparison cohort). Direct medical costs (in 2010 Canadian dollars [$]) were calculated based on billing records pertaining to hospital admissions, outpatient services use, medication dispensations, and community care services. We determined the excess medical costs of COPD by calculating the difference in overall medical costs between the COPD and the comparison cohorts.

RESULTS:  The COPD and comparison cohorts comprised 153,570 and 246,801 people, respectively (for both cohorts, mean age at entry was 66.9 years; 47.2% female patients). The excess costs of COPD during the study period were $5,452 per patient-year. Inpatient, outpatient, medication, and community care costs were responsible for 57%, 16%, 22%, and 5% of the excess costs, respectively. Excess costs increased by $296/person-y (P < .01), with hospital costs demonstrating the largest increase over time ($258/person-y; P < .01).

CONCLUSIONS:  The direct economic burden of COPD is high and has increased significantly between 2001 and 2010 over and above the increase in the health-care costs of the general population. Further investigation is required to elucidate the underlying reasons for the temporal increase in COPD direct costs.

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