Early COPD diagnosis could save billions

If 600,000 Swedish patients with chronic obstructive pulmonary disease (COPD) had received their diagnoses two years earlier, it could have saved more than SEK 15 billion in direct healthcare costs during the first two years after diagnosis. This is shown by research results from the ARCTIC study, conducted by researchers at Uppsala University and Karolinska Institutet. These results were presented at the Nordic Lung Congress in Visby, Gotland.

The new findings reported in Visby thus indicate that, over a two-year period, early COPD diagnosis could save the public purse approximately SEK 25,000 per patient in direct healthcare costs compared with late COPD diagnosis.

"Earlier COPD diagnosis could save the country huge sums in healthcare costs. In our study, we've focused on savings that are achievable during the first two years after COPD has been diagnosed," says Professor Christer Janson of Uppsala University, who contributed to the study.

Early diagnosis brings major advantages for patients during subsequent years, too, in the form of reduced risk of COPD worsening and fewer sequelae (complications), such as osteoporosis, arthritis, cardiovascular disease, cancer and mental illness. For the individual COPD patient, there are very large gains associated with early diagnosis.

Spirometry for more people a must

"Many COPD patients, unfortunately, believe they're generally in poor physical shape and think that's why they often get out of breath. But breathlessness can mean something much worse: that COPD is developing. Our study shows that the earlier the disease is detected, the better the scope for effective treatment and improved control of symptom development. This enables patients to lead more active lives without complications. The study shows a 60% lower risk of acute episodes of COPD becoming more severe with early diagnosis than with late. That's why it's crucial for the public and healthcare services to become more aware of the need for pulmonary function testing with spirometry as soon as people find they're often getting breathless," says Christer Janson.

Other findings from the study

• People diagnosed with COPD cost healthcare services five times as much as the control group who did not have COPD.
• People diagnosed with COPD had incomes half as high as those of the control group who did not have COPD.
• COPD patients diagnosed early have a 60% lower risk of the disease worsening
• Women with COPD are diagnosed later than men with COPD.

ARCTIC is one of the largest studies on COPD patients conducted in Sweden. The study is based on the electronic medical records (EMRs) of 17,545 COPD patients and 84,514 reference patients. ARCTIC comprises three different studies: one that focuses on the value of early vs. late COPD detection; one that investigates the complications associated with a COPD diagnosis; and, last, a study that has quantified the economic implications of COPD. Investigations of this kind are feasible since EMRs have been  used in Swedish healthcare for many years.