OBJECTIVE: In the studies carried out to date, the cost of chronic obstructive
pulmonary disease (COPD) may have been overestimated due to the inclusion
of previously diagnosed patients seeking medical attention for their symptoms.
As a result, the severity of the cases included in these studies may have
been greater than in an unselected sample of the general population. The
aim of the present study was to estimate the direct cost of COPD on the
basis of a representative sample of the overall Spanish population between
40 and 69 years of age (from the IBERPOC study). METHOD: The cost was
evaluated retrospectively by means of a questionnaire completed by the
363 patients with COPD from the IBERPOC study with questions referring
to the previous year. Standardized spirometry was performed on all the
patients by a pneumologist in each of the 7 geographical areas in which
the study was carried out. RESULTS: Hospitalization accounted for the
greatest expenditure (41% of total), followed by drug therapy (37%). The
cost was euro;98.39 per patient, and euro;909.50 per previously diagnosed
patient. The cost per person of severe COPD was more than 3 times that
of moderate COPD and more than 7 times that of mild COPD. The estimated
annual cost of COPD in Spain was euro;238.82 million (for 1997). CONCLUSION:
The present study, which was the first to estimate the cost of COPD in
a representative sample of the general population, found the cost to be
lower than in studies analyzing samples of patients with previous diagnoses
of COPD. The cost distribution is not in line with recommended health
care practices, underlining the need to optimize resources used to monitor
and treat the disease, with an emphasis on early diagnosis.