Chronic Obstructive Pulmonary Disease: Economic Burden in Russia and European Countries (Review)

INTRODUCTION. Chronic obstructive pulmonary disease (COPD) is a leading cause of death and significant economic losses for the healthcare system. While there is a trend towards decreasing COPD incidence in Europe, Russia saw the incidence increase by 5%, and the economic burden rose from 0.20% to 0.34% of GDP in 2022–2023. International and nationwide best practices necessitate a further analysis to identify the ways of reducing financial burden on the Russian healthcare system.

AIM. This study aimed to identify and evaluate feasibility for the most effective ways to reduce the financial burden when managing COPD patients in the Russian Federation.

DISCUSSION. Key differences in COPD epidemiology and cost structure were identified between Russia and EU countries. In the European Union (2001–2019), COPD incidence decreased among men (–9.7%) and increased among women (+4.3%) due to higher smoking rates. In Russia, the incidence continued to grow (+5%), while the mortality remained high (26% of the total death causes). In the EU, main direct costs were attributed to inpatient care (35–64%) and drug therapy (~25%), while the share of indirect costs reached 61–83%. Russian cost structure differed: the share of indirect costs was 92.6%, while among the direct costs, 76.1% was attributed to medicines supply, and only 18.7% covered inpatient care.

Effective burden reduction included: smoking cessation (reduced exacerbation risk by 39.7%; hazard ratio 0.65 for abstinence >10 years); prophylactic vaccinations (reduced hospitalizations by 50%, while vaccine refusal increased mortality 162-fold); modern pharmacotherapy (triple therapy: long-acting anticholinergic agents + long-acting beta2-agonists + inhaled glucocorticoids, reduced exacerbation frequency by 24% and mortality by 49%), and pulmonary rehabilitation (OR for hospital readmissions 0.44) still presented poorly in Russia (~10%).

CONCLUSIONS. To reduce COPD economic burden in the Russian Federation, it is necessary to increase the coverage with preventive measures (tobacco control programs, immunization), develop pulmonary rehabilitation programs using digital technologies, implement modern pharmacotherapy regimens, and improve physicians’ expertise via continuing medical education.

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