The annual cost of chronic obstructive pulmonary disease to the UK’s National Health Service.

Author: JF Guest.
Source: Disease Management & Health Outcomes 1999; 5(2): 93-100.

ABSTRACT

Objective: The objective of this study was to estimate the annual resource use and corresponding costs (at 1996/97 prices) to the UK’s National Health Service (NHS) arising from the management of chronic obstructive pulmonary disease (COPD).

Design and Setting: A subgroup analysis was performed on a previously published prevalence-based burden of illness analysis. The analysis estimated the annual cost to the NHS of managing all community-acquired lower respiratory tract infections (LRTIs) during 1992/93. As there have been few innovations in COPD management over the last 5 years, this subgroup analysis indicates the order of magnitude of annual resource use and corresponding costs.

Results: The subgroup analysis estimated that the NHS spends £817.5 million annually managing COPD. Inpatient stay for COPD cost £243.4 million annually, general practitioner (GP) consultations cost £236.5 million and outpatient clinic visits £35.0 million. Drugs prescribed by GPs cost an estimated £116.9 million with another £8.9 million attributable to hospital prescribing. GP-initiated and inpatient-based diagnostic tests accounted for £132.7 million and £11.2 million, respectively. Community nursing visits cost £2.0 million and NHS transport £18.4 million.

Conclusions: Hospitalisation accounts for approximately 35% of the expenditure. However, less than 2% of patients with COPD are admitted into hospital. The cost of a hospital admission to manage COPD was an estimated £3000. In contrast, the mean annual community cost was £100 per patient. Therefore, management strategies that reduce either the number of hospital admissions or the length of hospital stay could potentially reduce direct healthcare costs.