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* From the OLIN Studies, Department of Medicine (Dr. Jansson), Sunderby Central Hospital of Norrbotten, Luleå; Department of Respiratory Medicine and Allergy (Dr. Jönsson), University of Umeå, Umeå; AstraZeneca R&D (Drs. Andersson and Ericsson, and Mr. Borg), Lund; and Unit for Lung and Allergy Research (Dr. Lundbäck), National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Correspondence to: Bo Lundbäck, MD, PhD, Unit for Lung and Allergy Research, National Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden; e-mail: bo.lundback{at}telia.com
Objectives: COPD is a common and disabling disease that entails high costs for society. The objectives of this study were to measure the societal costs of COPD in Sweden, and to examine the relationship between severity of illness and costs.
Methods: The costs of COPD were examined using a well-defined and representative cohort of subjects with mild, moderate, and severe COPD. Regular telephone interviews regarding resource utilization were made to a cohort of 212 subjects with COPD derived from studies of the general population in Northern Sweden.
Results: The annual per capita cost for COPD in Swedish crowns (SEK) was estimated at SEK 13,418 (1,284 US dollars (USD); 1,448 euros (EUR). The direct and indirect costs were SEK 5,592 (42%) and SEK 7,828 (58%), respectively. A highly significant relationship was found between severity of disease and costs. Costs for severe disease were 3 times as high as costs for moderate disease and > 10 times as high as for mild disease. Large individual variations in the level of costs were found.
Conclusion: Assuming that the prevalence and treatment patterns are representative of Sweden as a whole, the total costs of COPD to society in 1999 were estimated at SEK 9.1 billion (USD 871 million; EUR 982 million). Subjects with mild disease (83%) accounted for 29%, while subjects with moderate disease (13%) accounted for 41% of the total costs. The subjects with severe disease (4%) accounted for the remainder (30%). Prevention, early diagnosis, and postponement of disease progression should have large monetary and policy implications.
Key Words: COPD • cost of illness • severity • Sweden
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