ABSTRACT
The worldwide social burden of chronic obstructive pulmonary disease (COPD) in
terms of days lost to disability is expected to increase from twelfth to fifth among all
chronic diseases from 1990 to 2020 (1). In the United States, COPD affects
approximately 1.9 million Americans and is one of the fastest growing causes of
morbidity and mortality (2,3). Given COPD’s prevalence and the duration of illness,
its economic impact-in terms of medical treatment expenditures and work loss due
to morbidity and premature mortality-is substantial for all societies. Studies have
shown that the primary ‘‘cost-driver’’ for COPD in developed countries is hospital
care for exacerbations, accounting for nearly 70% of all direct medical costs for this
disease (1). Therefore, new treatments to reduce the severity or frequency of
exacerbations could have a tremendous impact on the overall economic burden of
the disease.
