Once an employee has been diagnosed with COPD, one-on-one case management programs can be effective. Several important conclusions are relevant to the health plan perspective concerning the management of COPD. First, the number of patients with COPD is still growing as a result of the aging of the population and the significant time it takes to see the effect of reduced rates of smoking on the prevalence of COPD.

Second, the cost of caring for individuals with COPD is likely to increase as this patient group increases. Therefore, it is imperative to manage guidelines and use the most effective treatments available. Third, it is important that we have new treatment options in the quest to better manage patients with COPD. And yet, pharmaceutical innovation alone will not result in better management of COPD. In addition to new treatment options, we must better understand how to help patients improve their medication adherence.

Finally, helping physicians to manage these patients according to well-established guidelines will continue to be a major challenge. To adequately manage patients with COPD and to control the clinical and economic consequences of this disease, an equal amount of effort needs to be invested in finding new treatments, managing patients to established guidelines, educating physicians, working with employers, and better understanding how to motivate patients to comply with care routines.

Only by involving all stakeholders in this process will we be able to improve clinical outcomes and control costeffectively in patients with COPD. Stay up to date on the latest information you need to devise benefit designs, make coverage decisions, and further value-based healthcare! Sign up for our newsletter or print publications today by entering your contact information below and clicking "Subscribe".

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Physical activity and its determinants in severe chronic obstructive pulmonary disease. Med Sci Sports Exerc. This table shows the main limitations identified by the authors of the articles included in the monograph, with many of them agreeing on the difficulties identified. In summary, we can highlight the variability between countries both in terms of patients and health services , cultural differences and differences in health practices, recall and selection bias which can lead to an underestimation or overestimation of costs , difficulties in reaching the sample size, heterogeneity in designs between studies, differences in the level of COPD severity of the patients selected, and the non-inclusion of the costs of exacerbations in some of the articles.

See Table 3. As shown in Table 4 , the direct healthcare costs 17 articles , are the most studied and are present or referred to in 17 out of 18 studies. These are followed by studies analyzing indirect costs 13 articles , direct non-health costs 8 articles and finally, intangible costs 2 articles. The main structure presented by most of the studies starts with an analysis of direct health costs, followed by direct costs unrelated to health, and finally by indirect costs.

As traditionally occurs in cost-of-illness studies, the least studied costs were the intangible costs, since only 2 of the 18 studies included these in their research. This is possibly due to the lack of information and records and the difficulty of their evaluation, quantification, and subsequent analysis, since it is very difficult to create a monetary value for aspects such as health-related quality of life HRQoL or disability.

In short, the heterogeneity of the studies makes it difficult to compare results. In this regard, the cost varies greatly depending on the countries studied, whether they have public or private health systems and whether they are conducted in developed or developing countries.

In conclusion, a great variability was found in the costs reported in the studies, where the total cost per COPD patient varies strikingly between geographically distant areas. Starting with direct health care costs, the data are analyzed and presented for the different geographical areas studied.

Secondly, in the case of Asia, regarding the direct healthcare cost, no major significant differences were found among the developed Asian countries Japan, South Korea, Singapore, Taiwan, and China.

Considering the indirect costs the second most studied , starting again with Europe, Rehman et al. Finally, Patel et al. The following are direct non-health care costs, these types of costs are present in eight of the 18 articles analyzed in this review, many of which have already been included in the section on direct healthcare costs. There are some exceptions that report total direct costs, making no distinction between health and non-medical costs. Finally, only two authors included intangible costs in their articles.

In summary they established that patients with mild COPD spend 0. See Table 4. COPD is one of the main chronic diseases identified in developed countries.

The latest epidemiological data indicate a high growth rate, which is projected even more intensely into the future, mainly related to population aging and smoking, which is present in western societies with worrying figures. Its identified morbimortality is one of the factors that disrupts the economic stability of health institutions, which is one of the basic pillars of a nation, and consequently increases the costs attributable to society at large [ 1 , 2 ].

Regarding the characteristics of the selected articles Table 2 and their methodological aspects Table 3 , it is important to note that the variability of costs in the reported results are largely a consequence of methodological divergences and research objectives that impact the type of costs in the way existing resources are identified, measured, valued and consumed by COPD patients in the various study settings.

This variability may also be due in part to real differences between countries, such as epidemiological differences, differences in the sociodemographic characteristics of the patients included in the analyses, the main characteristics of the health systems in each area and even differences in the prevention and treatment of COPD and its complications, as well as the way professionals work and cultural differences.

In the case of the economic characteristics of the selected articles Table 4 , one of the limitations found was that health cost studies report their results in different currencies apart from some intangible cost studies.

As this systematic review comprises worldwide studies, each study was conducted in a different geographical setting, consequently presenting its results in different currencies euros, Indian rupee, Canadian dollar, or US dollar , as well as computing this value in different years, from for the oldest study to for the most recent. This, in turn makes it difficult to equate and compare results unanimously, which generates discrepancies and heterogeneity when presenting and reflecting on the results found.

Secondly, the studies identified in this review clearly show that there are not many studies that simultaneously estimate direct healthcare costs, direct non-medical care costs and indirect costs. Only three authors carried out such a study [ 12 , 14 , 18 ]. The scarce presence of non-medical costs, which refer to items such as the costs derived from personal care formal and informal and the transport or subsistence costs required by the disease, is noteworthy.

Less than half of the studies identified incorporated this item in some way, and if they did, in most cases they complemented healthcare costs. However, none of them included the family cost related to the care of persons as a consequence of the disease. Also, it is important to mention that some studies are based on the perspective of COPD cost calculation and others show the total attributable costs in COPD patients in this case older patients since the costs generated by the comorbidities and peculiarities of each patient in the study sample are also included.

In view of the objectives of this monograph, it is important to mention that the 18 cost studies identified in this systematic review indicate that COPD significantly increases overall economic costs, thus generating significantly higher excess costs for people with COPD, compared to people without the disease.

Regarding the factors that increase costs in COPD patients, after reading and analyzing the 18 articles included in the review, the main link that leads to the greatest increase in costs in this pathology is AECOPD acute exacerbation of COPD , the main complication, which occurs more frequently and is greater with more severe COPD and cases that are worse controlled.

Thus, the patients who generate the most costs within the disease are those who are in a moderate-severe stage of the disease and who, in addition, have the worst control of their pathology. Poor control of respiratory disease in general, and specifically in the COPD patient, is based on poor adherence to treatment and a lack of skill or technique in carrying out the prescribed pharmacological treatment. Finally, a breakdown by type of cost shows that all the authors reached the consensus that the main components of direct healthcare costs are hospitalizations produced in most cases by AECOPD and medication to treat these complications, whereas in general the other components medical visits, emergency visits, diagnostic tests are less relevant.

Likewise, regarding indirect costs, the studies identified highlight the importance that work losses can have as a consequence of the disease. These are reported by more than half of the authors included in the literature review. This aspect entails not only a loss for the employer or society as a whole, but also a direct impact on the economic stability of the individuals facing the disease and, consequently, also on their families or persons on whom their economic income depends.

In conclusion, given the importance of COPD, both for the health system and for society, it would be advisable to reassess the allocation of resources for the disease by taking into account the study of costs.

Ofchus knows he's lucky to have insurance that covers most of the costs associated with treating his COPD. Ofchus also uses a portable oxygen concentrator, a small machine that makes oxygen.

There are additional fees for tubing, filters, nasal cannulas, and other consumable accessories. The machines can be powered with an AC adapter adding to your electric bill or a battery. Eating a healthy diet and exercising are important aspects of managing COPD. Lack of exercise causes muscles to become weak, which causes them to need more oxygen and leads to shortness of breath.

Ofchus exercises to stay healthy by doing yoga. Making good choices when shopping for groceries is another way you can promote good health, but this is an area where you may want to spend a little extra.