The clinical and economic burden of chronic obstructive pulmonary disease in the USA

Anthony J. Guarascio, Shaunta' Chamberlin, Christopher K. Finch, Timothy Self

Research output: Contribution to journalReview article

145 Citations (Scopus)

Abstract

Chronic obstructive pulmonary disease (COPD) is the third most common cause of death in the USA. In 2010, the cost of COPD in the USA was projected to be approximately US$50 billion, which includes $20 billion in indirect costs and $30 billion in direct health care expenditures. These costs can be expected to continue to rise with this progressive disease. Costs increase with increasing severity of disease, and hospital stays account for the majority of these costs. Patients are diagnosed with COPD following a multi factorial assessment that includes spirometry, clinical presentation, symptomatology, and risk factors. Smoking cessation interventions are the most influential factor in COPD management. The primary goal of chronic COPD management is stabilization of chronic disease and prevention of acute exacerbations. Bronchodilators are the mainstay of COPD therapy. Patients with few symptoms and low exacerbation risk should be treated with a short-acting bronchodilator as needed for breathlessness. Progression of symptoms, as well as possible decline in forced expiratory volume in the first second of expiration (FEV1), warrant the use of long-acting bronchodilators. For patients with frequent exacerbations with or without consistent symptoms, inhaled corticosteroids should be considered in addition to a long-acting beta2-agonist (LABA) or long-acting muscarinic antagonist (LAMA) and may even consist of "triple therapy" with all three agents with more severe disease. Phosphodiesterase-4 inhibitors may be an option in patients with frequent exacerbations and symptoms of chronic bronchitis. In addition to a variety of novel ultra-LABAs, LAMAs and combination bronchodilator and inhaled corticosteroid (ICS) therapies, other bronchodilators with a variety of mechanisms are also being considered, to expand therapeutic options for the treatment of COPD. With more than 50 new medications in the pipeline for the treatment of COPD, optimal management will continue to evolve and grow more complex as benefits of therapy are balanced with the limitations and needs of each patient.

Original languageEnglish (US)
Pages (from-to)235-245
Number of pages11
JournalClinicoEconomics and Outcomes Research
Volume5
Issue number1
DOIs
StatePublished - Jun 25 2013

Fingerprint

Chronic Obstructive Pulmonary Disease
Economics
Bronchodilator Agents
Costs and Cost Analysis
Disease Management
Therapeutics
Adrenal Cortex Hormones
Phosphodiesterase 4 Inhibitors
Burden
Muscarinic Antagonists
Spirometry
Chronic Bronchitis
Forced Expiratory Volume
Smoking Cessation
Health Expenditures
Dyspnea
Cause of Death
Length of Stay
Chronic Disease
Delivery of Health Care

All Science Journal Classification (ASJC) codes

  • Economics, Econometrics and Finance (miscellaneous)
  • Health Policy

Cite this

The clinical and economic burden of chronic obstructive pulmonary disease in the USA. / Guarascio, Anthony J.; Chamberlin, Shaunta'; Finch, Christopher K.; Self, Timothy.

In: ClinicoEconomics and Outcomes Research, Vol. 5, No. 1, 25.06.2013, p. 235-245.

Research output: Contribution to journalReview article

Guarascio, Anthony J. ; Chamberlin, Shaunta' ; Finch, Christopher K. ; Self, Timothy. / The clinical and economic burden of chronic obstructive pulmonary disease in the USA. In: ClinicoEconomics and Outcomes Research. 2013 ; Vol. 5, No. 1. pp. 235-245.
@article{fc8196ed778f4da29faa17e9a92f01a4,
title = "The clinical and economic burden of chronic obstructive pulmonary disease in the USA",
abstract = "Chronic obstructive pulmonary disease (COPD) is the third most common cause of death in the USA. In 2010, the cost of COPD in the USA was projected to be approximately US$50 billion, which includes $20 billion in indirect costs and $30 billion in direct health care expenditures. These costs can be expected to continue to rise with this progressive disease. Costs increase with increasing severity of disease, and hospital stays account for the majority of these costs. Patients are diagnosed with COPD following a multi factorial assessment that includes spirometry, clinical presentation, symptomatology, and risk factors. Smoking cessation interventions are the most influential factor in COPD management. The primary goal of chronic COPD management is stabilization of chronic disease and prevention of acute exacerbations. Bronchodilators are the mainstay of COPD therapy. Patients with few symptoms and low exacerbation risk should be treated with a short-acting bronchodilator as needed for breathlessness. Progression of symptoms, as well as possible decline in forced expiratory volume in the first second of expiration (FEV1), warrant the use of long-acting bronchodilators. For patients with frequent exacerbations with or without consistent symptoms, inhaled corticosteroids should be considered in addition to a long-acting beta2-agonist (LABA) or long-acting muscarinic antagonist (LAMA) and may even consist of {"}triple therapy{"} with all three agents with more severe disease. Phosphodiesterase-4 inhibitors may be an option in patients with frequent exacerbations and symptoms of chronic bronchitis. In addition to a variety of novel ultra-LABAs, LAMAs and combination bronchodilator and inhaled corticosteroid (ICS) therapies, other bronchodilators with a variety of mechanisms are also being considered, to expand therapeutic options for the treatment of COPD. With more than 50 new medications in the pipeline for the treatment of COPD, optimal management will continue to evolve and grow more complex as benefits of therapy are balanced with the limitations and needs of each patient.",
author = "Guarascio, {Anthony J.} and Shaunta' Chamberlin and Finch, {Christopher K.} and Timothy Self",
year = "2013",
month = "6",
day = "25",
doi = "10.2147/CEOR.S34321",
language = "English (US)",
volume = "5",
pages = "235--245",
journal = "ClinicoEconomics and Outcomes Research",
issn = "1178-6981",
publisher = "Dove Medical Press Limited",
number = "1",

}

TY - JOUR

T1 - The clinical and economic burden of chronic obstructive pulmonary disease in the USA

AU - Guarascio, Anthony J.

AU - Chamberlin, Shaunta'

AU - Finch, Christopher K.

AU - Self, Timothy

PY - 2013/6/25

Y1 - 2013/6/25

N2 - Chronic obstructive pulmonary disease (COPD) is the third most common cause of death in the USA. In 2010, the cost of COPD in the USA was projected to be approximately US$50 billion, which includes $20 billion in indirect costs and $30 billion in direct health care expenditures. These costs can be expected to continue to rise with this progressive disease. Costs increase with increasing severity of disease, and hospital stays account for the majority of these costs. Patients are diagnosed with COPD following a multi factorial assessment that includes spirometry, clinical presentation, symptomatology, and risk factors. Smoking cessation interventions are the most influential factor in COPD management. The primary goal of chronic COPD management is stabilization of chronic disease and prevention of acute exacerbations. Bronchodilators are the mainstay of COPD therapy. Patients with few symptoms and low exacerbation risk should be treated with a short-acting bronchodilator as needed for breathlessness. Progression of symptoms, as well as possible decline in forced expiratory volume in the first second of expiration (FEV1), warrant the use of long-acting bronchodilators. For patients with frequent exacerbations with or without consistent symptoms, inhaled corticosteroids should be considered in addition to a long-acting beta2-agonist (LABA) or long-acting muscarinic antagonist (LAMA) and may even consist of "triple therapy" with all three agents with more severe disease. Phosphodiesterase-4 inhibitors may be an option in patients with frequent exacerbations and symptoms of chronic bronchitis. In addition to a variety of novel ultra-LABAs, LAMAs and combination bronchodilator and inhaled corticosteroid (ICS) therapies, other bronchodilators with a variety of mechanisms are also being considered, to expand therapeutic options for the treatment of COPD. With more than 50 new medications in the pipeline for the treatment of COPD, optimal management will continue to evolve and grow more complex as benefits of therapy are balanced with the limitations and needs of each patient.

AB - Chronic obstructive pulmonary disease (COPD) is the third most common cause of death in the USA. In 2010, the cost of COPD in the USA was projected to be approximately US$50 billion, which includes $20 billion in indirect costs and $30 billion in direct health care expenditures. These costs can be expected to continue to rise with this progressive disease. Costs increase with increasing severity of disease, and hospital stays account for the majority of these costs. Patients are diagnosed with COPD following a multi factorial assessment that includes spirometry, clinical presentation, symptomatology, and risk factors. Smoking cessation interventions are the most influential factor in COPD management. The primary goal of chronic COPD management is stabilization of chronic disease and prevention of acute exacerbations. Bronchodilators are the mainstay of COPD therapy. Patients with few symptoms and low exacerbation risk should be treated with a short-acting bronchodilator as needed for breathlessness. Progression of symptoms, as well as possible decline in forced expiratory volume in the first second of expiration (FEV1), warrant the use of long-acting bronchodilators. For patients with frequent exacerbations with or without consistent symptoms, inhaled corticosteroids should be considered in addition to a long-acting beta2-agonist (LABA) or long-acting muscarinic antagonist (LAMA) and may even consist of "triple therapy" with all three agents with more severe disease. Phosphodiesterase-4 inhibitors may be an option in patients with frequent exacerbations and symptoms of chronic bronchitis. In addition to a variety of novel ultra-LABAs, LAMAs and combination bronchodilator and inhaled corticosteroid (ICS) therapies, other bronchodilators with a variety of mechanisms are also being considered, to expand therapeutic options for the treatment of COPD. With more than 50 new medications in the pipeline for the treatment of COPD, optimal management will continue to evolve and grow more complex as benefits of therapy are balanced with the limitations and needs of each patient.

UR - http://www.scopus.com/inward/record.url?scp=84879139127&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84879139127&partnerID=8YFLogxK

U2 - 10.2147/CEOR.S34321

DO - 10.2147/CEOR.S34321

M3 - Review article

VL - 5

SP - 235

EP - 245

JO - ClinicoEconomics and Outcomes Research

JF - ClinicoEconomics and Outcomes Research

SN - 1178-6981

IS - 1

ER -