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Present and future costs of COPD in Iceland and Norway: results from the BOLD study

¹ Section of Thoracic Medicine, Institute of Medicine, University of Bergen, Bergen, Norway, ² Dept of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway, ³ Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway, ⁴ Faculty of Medicine, University of Iceland, Iceland, ⁵ Oregon Health and Sciences University, Portland, OR, USA, ⁶ Depts of Pharmacy and Health Services, University of Washington, Seattle, WA, USA, ⁷ Center for Management of Complex Chronic Care (CMC³), Hines VA Hospital, Hines, IL, USA, and ⁸ Institute for Healthcare Studies and Division of General Internal Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.

CORRESPONDENCE: R. Nielsen, Lungeavdelingen, Haukeland University Hospital, N-5021 Bergen, Norway. E-mail: rune.nielsen{at}med.uib.no

Keywords: Chronic obstructive pulmonary disease, computer simulation, cost of illness, disease progression, Iceland, Markov chains, Norway

Received: November 4, 2008
Accepted March 26, 2009

The Burden of Obstructive Lung Disease (BOLD) initiative provides standardised estimates of the burden of chronic obstructive pulmonary disease (COPD) worldwide. We estimate the current and future economic burden of COPD in Reykjavik, Iceland and Bergen, Norway using data from the BOLD initiative.

Data on utilisation of healthcare resources were gathered from the BOLD survey, existing literature and unit costs from national sources. Economic data were applied to a Markov model using transition probabilities derived from Framingham data. Sensitivity analyses were conducted varying unit costs, utilisation and prevalence of disease.

The cost of COPD was \#8364;478 per patient per yr in Iceland and \#8364;284 per patient per yr in Norway. The estimated cumulative costs of COPD for the population aged 40 yrs, were \#8364;130 million and \#8364;1,539 million for the following 10 yrs in Iceland and Norway, respectively. Costs of COPD accounted for 1.2 and 0.7% of healthcare budgets in Iceland and Norway, respectively. Sensitivity analyses showed estimates were most sensitive to changes in exacerbation frequency.

COPD has a significant economic burden in both Iceland and Norway and will grow in the future. Interventions aimed at avoiding exacerbations will have the most impact on costs of COPD over the next 20 yrs.