2020-50 年全球 204 个国家和地区慢性阻塞性肺疾病的全球经济负担：一项健康增强型宏观经济建模研究。
The global economic burden of chronic obstructive pulmonary disease for 204 countries and territories in 2020-50: a health-augmented macroeconomic modelling study.
机构信息
Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany; Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
International Institute for Applied Systems Analysis, Laxenburg, Austria; Wittgenstein Centre, Vienna, Austria.
出版信息
Lancet Glob Health. 2023 Aug;11(8):e1183-e1193. doi: 10.1016/S2214-109X(23)00217-6.
BACKGROUND
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide and imposes a substantial economic burden. Gaining a thorough understanding of the economic implications of COPD is an important prerequisite for sound, evidence-based policy making. We aimed to estimate the macroeconomic burden of COPD for each country and establish its distribution across world regions.
METHODS
In this health-augmented macroeconomic modelling study we estimated the macroeconomic burden of COPD for 204 countries and territories over the period 2020-50. The model accounted for (1) the effect of COPD mortality and morbidity on labour supply, (2) age and sex specific differences in education and work experience among those affected by COPD, and (3) the impact of COPD treatment costs on physical capital accumulation. We obtained data from various public sources including the Global Burden of Disease Study 2019, the World Bank database, and the literature. The macroeconomic burden of COPD was assessed by comparing gross domestic product (GDP) between a scenario projecting disease prevalence based on current estimates and a counterfactual scenario with zero COPD prevalence from 2020 to 2050.
FINDINGS
Our findings suggest that COPD will cost the world economy INT$4·326 trillion (uncertainty interval 3·327-5·516; at constant 2017 prices) in 2020-50. This economic effect is equivalent to a yearly tax of 0·111% (0·085-0·141) on global GDP. China and the USA face the largest economic burdens from COPD, accounting for INT$1·363 trillion (uncertainty interval 1·034-1·801) and INT$1·037 trillion (0·868-1·175), respectively.
INTERPRETATION
The macroeconomic burden of COPD is large and unequally distributed across countries, world regions, and income levels. Our study stresses the urgent need to invest in global efforts to curb the health and economic burdens of COPD. Investments in effective interventions against COPD do not represent a burden but could instead provide substantial economic returns in the foreseeable future.
FUNDING
Alexander von Humboldt Foundation, National Natural Science Foundation of China, CAMS Innovation Fund for Medical Science, Chinese Academy of Engineering project, Chinese Academy of Medical Sciences and Peking Union Medical College project, and Horizon Europe.
TRANSLATIONS
For the Chinese and German translations of the abstract see Supplementary Materials section.
背景
慢性阻塞性肺疾病（COPD）是全球第三大致死原因，给经济造成了巨大负担。深入了解 COPD 的经济影响是制定合理循证政策的重要前提。我们旨在估算每个国家 COPD 的宏观经济负担，并确定其在世界各区域的分布情况。
方法
在这项健康增强型宏观经济模型研究中，我们估算了 204 个国家和地区在 2020-50 年期间 COPD 的宏观经济负担。该模型考虑了以下因素：（1）COPD 死亡率和发病率对劳动力供给的影响；（2）受 COPD 影响人群的教育和工作经验在年龄和性别上的差异；（3）COPD 治疗费用对实物资本积累的影响。我们从全球疾病负担研究 2019、世界银行数据库和文献等各种公共来源获取数据。通过比较基于当前估计的疾病流行率预测情景和 2020-50 年期间 COPD 流行率为零的反事实情景，评估 COPD 的宏观经济负担。
发现
我们的研究结果表明，2020-50 年 COPD 将使全球经济损失 43260 亿美元（2017 年不变价，区间为 33270-55160 亿美元）。这一经济影响相当于全球 GDP 的 0.111%（0.085-0.141）的年度税收。中国和美国面临的 COPD 经济负担最大，分别为 13630 亿美元（9340-17960 亿美元）和 10370 亿美元（8680-11750 亿美元）。
解释
COPD 的宏观经济负担很大，且在国家、世界区域和收入水平之间分布不均。我们的研究强调迫切需要投资于全球努力，以遏制 COPD 的健康和经济负担。对 COPD 有效干预措施的投资不会造成负担，反而可能在可预见的未来带来可观的经济回报。
资金
亚历山大·冯·洪堡基金会、国家自然科学基金委员会、中国医学科学院医学与健康科技创新工程、中国工程院项目、中国医学科学院和北京协和医学院项目、以及欧洲地平线计划。
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