Economic impact of reducing COPD burden and disease severity: a scenario analysis for Germany

Background

Chronic obstructive pulmonary disease (COPD) imposes a high burden on population health and healthcare systems. While years lived with disability (YLD) quantify morbidity, their translation into economic impact remains limited. This study links severity-specific cases and YLD for COPD with direct and indirect healthcare costs.

Methods

A scenario analysis used estimates of COPD cases and YLD for Germany (2022). YLD were estimated based on COPD prevalence from statutory health insurance claims (AOK), extrapolated to the German population, and disability weights from the Global Burden of Disease study. YLD severity categories were assigned to GOLD stages (GOLD 1 to mild, GOLD 2 to moderate, GOLD 3–4 to severe). The distribution of GOLD stages were derived from data of the German disease management program for COPD (Kirsch et al. 2019). Direct and indirect costs were estimated by applying severity-specific annual per-case costs (Kirsch et al. 2019, inflated to 2022). Two scenarios were modelled: (1) reductions in moderate and severe COPD (3%/5%, 5%/10%, 10%/15%) and (2) reassigning 10% of severe cases to moderate. Outcomes included avoided YLD and cost savings.

Results

Substantial total costs are driven by moderate and severe stages. In the reduction scenario, avoided YLD ranged from 7,341 to 23,342 and direct cost savings from €365 million to €1.15 billion across scenarios for one year (€49,000-50,500 per avoided YLD). The shift scenario (2) alone reduced direct costs by €118 million. Including indirect costs increased total savings in (1) to €0.77-€2.43 billion and (2) to €210 million.

Conclusions

Avoiding COPD burden, particularly in severe stages, can yield substantial cost savings and health gains. Slowing disease progression represents a key intervention lever. When also considering indirect costs, total potential savings can more than double. Integrating burden of disease and cost analyses can provide additional evidence for public health decisions.

Key messages

• Reducing moderate and severe COPD could avoid 7,341 to 23,342 YLD and save €365 million to €1.15 billion in direct healthcare costs.

• Interventions that slow COPD progression can generate meaningful savings: shifting 10% of severe cases to moderate was estimated to save up to €118 million in direct costs.