Hospitalizations, comorbidities drive up costs for COPD

THE COST OF chronic obstructive pulmonary disorder (COPD) in terms of medical bills and lost productivity, according to the National Heart Lung and Blood Institute (NHLBI), totals $50 billion a year. And the price tag is going up, making it a chronic condition payers can't afford to ignore.

"Most patients with COPD die with COPD rather than from their COPD," Dr. Thomashow says.

"Unlike chest pain or terrible headaches or diarrhea that land a person in their doctor's office, lung disease gets self-diagnosed and self-treated," says Dr. Thomashow. "People experience shortness of breath, and they self-diagnose it as getting older or gaining weight. They self-treat by cutting back on activity."

LEADING CAUSE OF DEATH

COPD refers to a group of diseases, including emphysema and chronic bronchitis, which cause airflow blockage and breathing-related problems. The disease kills 120,000 Americans a year, making it the fourth leading cause of death. By 2020, the Centers for Disease Control and Prevention (CDC) expects it to take over the No. 3 spot.

Once considered an old man's disease, COPD is increasingly striking working-age adults: Roughly half the 12 million Americans diagnosed with COPD are under age 65, according to NHLBI. Women are particularly at risk.

COPD is typically caused by long-term smoking-four out of five COPD patients are former or current smokers-but can manifest years after a smoker has kicked the habit. While the peak smoking period for men was in the 1960s, according to Dr. Thomashow, that's when many women were also taking up the habit. What's more, women appear to be more susceptible to the effects of the related toxins, he says. The combination of the two factors caused the death rate from COPD among women to triple between 1980 and 2000. Today COPD kills more women than men.

Collectively, these trends have a huge impact on employers, both in terms of treatment costs and lost worker productivity.

A 2009 report published by the COPD Foundation found that individuals between age 40 and 65 with COPD miss as many as 10 hours of work per week because of their condition. In addition, COPD is the second leading cause of disability, according to the American Lung Assn.

A survey conducted by the NHLBI last year found that less than half of respondents realized that COPD was treatable, and 41% of current smokers do not talk to their doctors about their COPD symptoms because they don't want to hear another "quit smoking" message.