title: Health economic costs of COPD in Sweden by disease severity--has it changed during a ten years period?
abstract: OBJECTIVE
  The objectives of the presented study were to estimate societal costs of COPD in Sweden, the relationship between costs and disease severity, and possible changes in the costs during the last decade.
  
  
  METHODS
  Subjects with COPD derived from the general population in Northern Sweden were interviewed by telephone regarding their resource utilisation and productivity losses four times quarterly during 2009-10. Mean annual costs were estimated for each severity stage of COPD.
  
  
  RESULTS
  A strong relationship was found between disease severity and costs. Estimated mean annual costs per subject of mild, moderate, severe and very severe COPD amounted to 596 (SEK 5686), 3245 (SEK 30,957), 5686 (SEK 54,242), and 17,355 euros (SEK 165,569), respectively. The main cost drivers for direct costs were hospitalisations (for very severe COPD) and drugs (all other severity stages). The main cost driver for indirect costs was productivity loss due to sick-leave (for mild COPD) and early retirement (all other severity stages). Costs appeared to be lower in 2010 than in 1999 for subjects with severe and very severe COPD, but higher for those with mild and moderate COPD.
  
  
  CONCLUSIONS
  Our results show that costs of COPD are strongly related to disease severity, and scaling the data to the whole Swedish population indicates that the total costs in Sweden amounted to 1.5 billion euros (SEK 13.9 bn) in 2010. In addition, costs have decreased since 1999 for subjects with severe and very severe COPD, but increased for those with mild and moderate COPD.
authors.affiliation: The OLIN Studies, Norrbotten County Council, Robertsviksgatan 9, SE-971 89 Luleå, Sweden; Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, SE-901 87 Umeå, Sweden. Electronic address: sven-arne.jansson@ki.se.
authors.forename: Sven-Arne
authors.initials: SA
authors.lastname: Jansson
authors.forename: Helena
authors.initials: H
authors.lastname: Backman
authors.forename: Anna
authors.initials: A
authors.lastname: Stenling
authors.forename: Anne
authors.initials: A
authors.lastname: Lindberg
authors.forename: Eva
authors.initials: E
authors.lastname: Rönmark
authors.forename: Bo
authors.initials: B
authors.lastname: Lundbäck
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000191:economics* / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology
keywords: CI; COPD; Cost analysis; FEV(1); GOLD; Global Initiative for Chronic Obstructive Lung Disease; Health economic aspects of COPD; OLIN; Obstructive Lung Disease in Northern Sweden; SEK; Swedish Krona; chronic obstructive pulmonary disease; confidence interval; forced expiratory volume in 1 s