Health expenditure

The financial cost of COPD is very large. In 1993, it was calculated that it created annual costs of US$23.9 billion to the US economy. This included US$ 14.7 billion for direct medical costs, with the remainder representing costs resulting from morbidity and premature mortality [31]. The direct health costs of COPD in the UK have been estimated at £846million (US$1.4 billion), accounting for 11% of all expenditure on prescription medications [32]. Typically, the expenditure on COPD is disproportionately distributed, with approximately 10% of patients accounting for 75% of expenditure.

In the UK (figures adapted from [33]), a typical primary-care group caring for a population of 100 000 will have:

• 1000 diagnosed cases of COPD

• 238 annual admissions due to COPD

• 55 deaths from COPD annually (25% below aged 65)

• General practitioner consultations costing £44 000 annually

• Drug therapy costing £718 per patient per year (asthma £198).

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