Amegadzie Joseph Emil, Mehareen Jeenat, Khakban Amir, Joshi Phalgun, Carlsten Chris, Sadatsafavi Mohsen
Respiratory Evaluation Sciences Program, Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.
Legacy for Airway Health and Centre for Lung Health, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.
Eur Respir J. 2025 Jan 30;65(1). doi: 10.1183/13993003.00516-2024. Print 2025 Jan.
Several major risk factors for COPD, such as population ageing, smoking rates and air pollution levels, are rapidly changing, causing inevitable changes in the population burden of COPD. We determined the excess direct costs of COPD and their trend from 2001 to 2020.
Using administrative health data from British Columbia, Canada, we created a retrospective matched cohort of physician-diagnosed COPD patients and non-COPD individuals. Excess direct medical costs (in 2020 Canadian dollars (CAD)) were estimated by analysing hospital records, outpatient services, medications and community care services. Comorbidity classes were assessed using International Classification of Diseases codes. Excess COPD costs were estimated as the adjusted difference in direct medical costs between the COPD and non-COPD cohorts.
There were 208 554 and 404 703 individuals in the COPD and non-COPD cohorts, respectively (47.8% female; mean baseline age 69.1 and 68.2 years, respectively). Direct medical costs for COPD were CAD 9224 per patient-year compared to CAD 3396 per patient-year for non-COPD, giving rise to excess costs of CAD 5828 (95% CI 5759-5897) per patient-year. Excess costs increased by 48% over the study period. Excess costs due to comorbidities were CAD 3588 (95% CI 3554-3622) per patient-year, with cardiovascular-related conditions alone exceeding the costs attributed to COPD (CAD 1375 904 per patient-year).
Despite multifaceted prevention and management initiatives, COPD-related economic burden is increasing, with the majority of costs due to comorbid conditions. Rising per-patient costs, combined with the flat or increasing prevalence of COPD in many jurisdictions, indicates a significant increase in COPD burden.
慢性阻塞性肺疾病（COPD）的几个主要风险因素，如人口老龄化、吸烟率和空气污染水平，正在迅速变化，导致COPD的人群负担不可避免地发生变化。我们确定了2001年至2020年COPD的额外直接成本及其趋势。
利用加拿大不列颠哥伦比亚省的行政卫生数据，我们创建了一个经医生诊断的COPD患者和非COPD个体的回顾性匹配队列。通过分析医院记录、门诊服务、药物和社区护理服务来估计额外的直接医疗成本（以2020年加拿大元（CAD）计）。使用国际疾病分类代码评估合并症类别。COPD的额外成本估计为COPD队列和非COPD队列之间直接医疗成本的调整差异。
COPD队列和非COPD队列分别有208554人和404703人（女性占47.8%；平均基线年龄分别为69.1岁和68.2岁）。COPD患者的直接医疗成本为每人每年9224加元，而非COPD患者为每人每年3396加元，导致每人每年额外成本为5828加元（95%CI 5759 - 5897）。在研究期间，额外成本增加了48%。合并症导致的额外成本为每人每年3588加元（95%CI 3554 - 3622），仅心血管相关疾病的成本就超过了归因于COPD的成本（每人每年1375加元对904加元）。
尽管有多方面的预防和管理举措，但与COPD相关的经济负担仍在增加，大部分成本归因于合并症。每位患者成本的上升，加上许多地区COPD患病率持平或上升，表明COPD负担显著增加。
