The burden of COPD in The Netherlands: results from the Confronting COPD survey.

Chronic obstructive pulmonary disease (COPD) is a disabling condition associated with progressive airflow limitation that is largely irreversible, with symptoms of dyspnoea, cough and sputum production. In The Netherlands, COPD tends to be underpresented to physicians, underdiagnosed and undertreated by healthcare professionals, and poorly recognized among the general population. Improving the diagnosis and management of COPD in this country may require raised awareness of the impact of the disease on society. This may be achieved by providing detailed information on the burden of COPD on the patient, healthcare system and the economy. This information has now become available from Confronting COPD in North America and Europe, the first international survey to quantify the country-specific impact of the disease. An economic analysis of the results of the Dutch survey revealed the high cost of COPD to the healthcare system and society, with direct costs estimated at Euro 614 per patient Indirect costs amounted to Euro 410, bringing the annual per patient cost of COPD to Euro 1024. Around 50% of the cost of COPD to the healthcare system was for prescription medication, including symptomatic medication and treatment for underlying airway inflammation. This contributed to effective symptom control in many patients, as shown by the low utilization of unscheduled healthcare (inpatient hospitalizations, emergency room visits, or contacts with healthcare professionals). However, the survey suggested that there was scope for improvement in the understanding of the origin and consequences of this disease among the general public, and the way COPD is managed by healthcare professionals, in order to increase the proportion of patients who are diagnosed with COPD and treated in accordance with management guidelines. In addition, smoking cessation intervention at the early stages of the disease could help to reduce the high costs associated with severe COPD in this country.