Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD, USA.
School of Public Health, Fudan University, Shanghai, China.
Value Health Reg Issues. 2022 Nov;32:8-16. doi: 10.1016/j.vhri.2022.06.002. Epub 2022 Aug 10.
Despite a growing prevalence of respiratory diseases in recent decades in China, limited evidence is available on the health and economic burden of chronic obstructive pulmonary disease (COPD). We estimated the 20-year health and economic burden of COPD in China from 2020 to 2039.
We created a probabilistic dynamic open-cohort Markov model of COPD for the Chinese population aged ≥40 years. Projections of population growth and urbanization rates were obtained from the United Nations Population Division. Other parameter inputs including smoking prevalence, COPD prevalence and severity distributions, disease-related costs, and utility weights were obtained from the most recent published literature. We modeled number of COPD patients, excess mortality due to COPD, exacerbations, COPD-attributable losses of quality-adjusted life-years, and direct and indirect COPD costs over the 20 years.
The number of COPD patients was projected to increase from 88.3 million in 2020 to 103.3 million in 2039. The projected total losses of quality-adjusted life-years and the excess mortality due to COPD were, respectively, estimated to be 253.6 million and 3.9 million over the 20 years. The projected 20-year total discounted direct and indirect costs of COPD were, respectively, $3.1 trillion and $360.5 billion. The projected health and economic burden was higher in males and urban areas.
COPD is projected to inflict a substantial burden to the society and the health care system in China. Effective strategies for prevention and early management of COPD are needed to mitigate the forthcoming disease burden.
尽管近几十年来中国的呼吸系统疾病患病率不断上升，但有关慢性阻塞性肺疾病（COPD）的健康和经济负担的证据有限。我们估算了 2020 年至 2039 年期间中国 COPD 的 20 年健康和经济负担。
我们为中国≥40 岁人群创建了 COPD 的概率性动态开放队列马尔可夫模型。人口增长率和城市化率的预测数据来自联合国人口司。其他参数输入，包括吸烟率、COPD 患病率和严重程度分布、疾病相关成本和效用权重，均来自最新发表的文献。我们对 20 年内 COPD 患者人数、因 COPD 导致的超额死亡率、加重率、COPD 导致的质量调整生命年损失以及直接和间接 COPD 成本进行了建模。
预计 COPD 患者人数将从 2020 年的 8830 万增加到 2039 年的 1.033 亿。预计 20 年内质量调整生命年损失和因 COPD 导致的超额死亡率分别为 2.536 亿和 390 万。预计 20 年 COPD 的总贴现直接和间接成本分别为 31 万亿美元和 3605 亿美元。预计男性和城市地区的健康和经济负担更高。
预计 COPD 将给中国社会和医疗保健系统带来巨大负担。需要采取有效的预防和早期管理 COPD 的策略来减轻即将到来的疾病负担。
