Disease Burden and Health-Related Quality of Life (HRQoL) of Chronic Obstructive Pulmonary Disease (COPD) in the US - Evidence from the Medical Expenditure Panel Survey (MEPS) from 2016-2019

Melissa H Roberts; David M Mannino; Douglas W Mapel; Orsolya Lunacsek; Shahla Amin; Eileen Farrelly; Norbert Feigler; Michael F Pollack

doi:10.2147/COPD.S446696

Disease Burden and Health-Related Quality of Life (HRQoL) of Chronic Obstructive Pulmonary Disease (COPD) in the US - Evidence from the Medical Expenditure Panel Survey (MEPS) from 2016-2019

Int J Chron Obstruct Pulmon Dis. 2024 May 13:19:1033-1046. doi: 10.2147/COPD.S446696. eCollection 2024.

Authors

Melissa H Roberts¹, David M Mannino^{2

3}, Douglas W Mapel⁴, Orsolya Lunacsek⁵, Shahla Amin⁵, Eileen Farrelly⁵, Norbert Feigler⁶, Michael F Pollack⁶

Affiliations

¹ College of Pharmacy, University of New Mexico, Albuquerque, NM, USA.
² College of Medicine, University of Kentucky, Lexington, KY, USA.
³ COPD Foundation, Miami, FL, USA.
⁴ Northern Arizona Pulmonary Associates, Flagstaff, AZ, USA.
⁵ Global Consulting, Cencora, Conshohocken, PA, USA.
⁶ BioPharmaceuticals, US Medical, AstraZeneca, Wilmington, DE, USA.

Abstract

Purpose: Chronic obstructive pulmonary disease (COPD) is a progressive disease associated with reduced life expectancy, increased morbidity, mortality, and cost. This study characterized the US COPD burden, including socioeconomic and health-related quality of life (HRQoL) outcomes.

Study design and methods: In this retrospective, cross-sectional study using nationally representative estimates from Medical Expenditures Survey (MEPS) data (2016-2019), adults (≥18 years) living with and without COPD were identified. Adults living without COPD (control cohort) and with COPD were matched 5:1 on age, sex, geographic region, and entry year. Demographics, clinical characteristics, socioeconomic, and generic HRQoL measures were examined to include a race-stratified analysis of people living with COPD.

Results: A total of 4,135 people living with COPD were identified; the matched dataset represented a weighted non-institutionalized population of 11.3 million with and 54.2 million people without COPD. Among people living with COPD, 66.3% had ≥1 COPD-related condition; 62.7% had ≥1 cardiovascular condition, compared to 33.5% and 50.5% without COPD. More people living with COPD were unemployed (56.2% vs 45.3%), unable to work due to illness/disability (30.1% vs 12.1%), had problems paying bills (16.1% vs 8.8%), reported poorer perceived health (fair/poor: 36.2% vs 14.4%), missed more working days due to illness/injury per year (median, 2.5 days vs 0.0 days), and had limitations in physical functioning (40.1% vs 19.4%) (all P<0.0001). In race-stratified analyses for people living with COPD, people self-reporting as Black had higher prevalence of cardiovascular-risk conditions, poorer socioeconomic and HRQoL outcomes, and higher healthcare expenses than White or Other races.

Conclusion: Adults living with COPD had higher clinical disease burden, lower socioeconomic status, and reduced HRQoL than those without, with greater disparities among Black people living with COPD compared to White and other races. Understanding the characteristics of patients helps address care disparities and access challenges.

Keywords: COPD; burden of illness; healthcare cost; race/ethnicity.

MeSH terms

Adolescent
Adult
Aged
Comorbidity
Cost of Illness*
Cross-Sectional Studies
Female
Health Expenditures*
Health Status
Humans
Male
Middle Aged
Pulmonary Disease, Chronic Obstructive* / economics
Pulmonary Disease, Chronic Obstructive* / epidemiology
Quality of Life*
Retrospective Studies
Socioeconomic Factors
Time Factors
United States / epidemiology
Young Adult

Grants and funding

AstraZeneca Pharmaceuticals LP provided funding for the research and the manuscript. The sponsor provided financial support for conducting the research. The sponsor provided oversight in the design of the study, the collection and analysis of the data, and the preparation of the manuscript.