Burden Of Obstructive Lung Disease Initiative Research Articles

Raising the awareness: projecting the future burden of COPD with the BOLD model

Not so long ago, cost-of-illness studies were criticised for mainly estimating the annual costs of a disease in retrospect, without paying attention to trends in costs and the return on the investments in terms of health benefits. From the time when we began developing models that can simulate the future burden and costs of a disease, we recognised the importance of cost-of-illness studies for providing insight into future healthcare needs and planning purposes. Providing this insight is one of the goals of the Burden of Obstructive Lung Disease (BOLD) project. The BOLD project aims to measure the prevalence of chronic obstructive pulmonary disease (COPD) among the population aged ≥40 yrs, its risk factors and its impact on quality of life, activity limitation, respiratory symptoms and use of healthcare services in various countries around the world, using a standardised protocol that includes spirometry 1, 2. Among the primary objectives of the BOLD initiative was the development of a COPD health economic model to make projections of the burden of COPD in the future. In the current issue of the European Respiratory Journal , Nielsen et al. 3 have used this model to estimate the current and future costs of COPD in Iceland and Norway over a 10- and 20-yr period. These are the first cost-of-illness data for COPD in these countries. The 10-yr costs of COPD were estimated to be \#8364;130 million in Iceland and \#8364;1,539 million in Norway (price level 2005; 3% discounting). The annual costs of COPD accounted for 1.2% and 0.7% of the healthcare budgets in Iceland and Norway. Given that the COPD prevalence, as found in the BOLD survey (17% in Iceland and 19% in Norway), is higher than typically reported in previous studies 4, 5, these estimates are surprisingly in line with other …

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

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 478 euro per patient per yr in Iceland and 284 euro per patient per yr in Norway. The estimated cumulative costs of COPD for the population aged > or = 40 yrs, were 130 million euro and 1,539 million euro 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.