Patients with chronic obstructive pulmonary disease who work are costly to their employers in both direct and indirect costs and have greater productivity losses, according to a recent study.
Patients with chronic obstructive pulmonary disease (COPD) who work are costly to their employers in both direct and indirect costs and have greater productivity losses, according to a recent study.
Using commercial insurance data between 2007 and 2010, the study looked at a nationally representative sample of working age patients aged 18 to 65 with COPD with employer-sponsored insurance.
In the United States, direct healthcare expenditures for COPD account for more than half of the national projected economic cost for this disease ($30 billion of $49.9 billion, according to a 2010 estimate). Indirect costs from illness, primarily associated with lost productivity, are responsible for $8 billion of the projected total cost. Indirect mortality costs account for $14.8 billion.
By 2020, COPD, which is largely preventable and often stems from smoking, is expected to be the third-leading cause of death.
In this study, patients were included if they had at least 1 hospitalization or 1 emergency department visit or 2 outpatient visits. The average age of the participant was 53 and most were male (67.5%).
Direct cost estimates were computed using paid amounts on all medical and pharmacy claims, regardless of diagnosis. Indirect costs were estimated from the costs paid for short-term disability claims.
Patients with very severe disease (classified according to the Global Initiative for Chronic Obstructive Lung Disease criteria) incurred up to 6 times the cost of a non-COPD control group, the authors noted.
Of the 5701 patients with COPD, 3.6% patients were frequent exacerbators (≤2 times), 10.4% patients were infrequent exacerbators (1 time), and 86% patients were nonexacerbators (0 times). When compared with the 17,103 patients without COPD, the incremental direct cost of COPD was estimated at $6246 per patient per year (95% CI: $4620, $8623; P < .001).
Loss in productivity was significantly greater in patients with COPD, with an average of 5 more days per year of absence from work and incremental indirect costs from short-term disability of $641 (P < .001).
Direct costs for frequent exacerbators ($17,651 per year) and infrequent exacerbators ($14,501 per year) were significantly higher than those for non-exacerbators ($11,395, P < .001).
This study reveals a number of statistically significant predictors of high incremental costs associated with COPD, and found that productivity claims associated with COPD were responsible for 10% of the overall cost burden. Direct costs for patients with frequent exacerbations were 22% higher than for patients with infrequent exacerbations and 55% higher than for those classified as non-exacerbators.
The authors said the estimate of indirect costs may actually be underestimated, as the only proxy used was short-term disability. It did not include absenteeism, presenteeism, or long-term disability.
Patel JG, Coutinho AD, Lunacsek OE, Dalal AA. [published onlione July 30, 2018]. COPD affects worker productivity and health care costs. Int J Chron Obstruct Pulmon Dis. doi: 10.2147/COPD.S163795.